Provider Demographics
NPI:1083683775
Name:NATRIGO-WATERS, TONI CAROL (LMSW LISW CP)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:CAROL
Last Name:NATRIGO-WATERS
Suffix:
Gender:F
Credentials:LMSW LISW CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 FARROW RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-7607
Mailing Address - Country:US
Mailing Address - Phone:803-434-1210
Mailing Address - Fax:803-434-1212
Practice Address - Street 1:3010 FARROW RD
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-7607
Practice Address - Country:US
Practice Address - Phone:803-434-3191
Practice Address - Fax:831-434-1212
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC69231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGM0760Medicaid
SCGM0760Medicaid