Provider Demographics
NPI:1063576460
Name:SAMARGHITAN, CORINA MARIA (MRC)
Entity type:Individual
Prefix:MISS
First Name:CORINA
Middle Name:MARIA
Last Name:SAMARGHITAN
Suffix:
Gender:F
Credentials:MRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 WESTBROOK DR APT I1
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-8978
Mailing Address - Country:US
Mailing Address - Phone:864-554-5019
Mailing Address - Fax:
Practice Address - Street 1:1547 PARKWAY STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4081
Practice Address - Country:US
Practice Address - Phone:864-223-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC421504Medicaid
SC3430Medicare ID - Type Unspecified