Provider Demographics
NPI:1316166168
Name:MARON, EVA (LISW-CP)
Entity type:Individual
Prefix:MS
First Name:EVA
Middle Name:
Last Name:MARON
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SPRING WATER DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-9233
Mailing Address - Country:US
Mailing Address - Phone:803-602-4369
Mailing Address - Fax:
Practice Address - Street 1:104 SPRING WATER DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-9233
Practice Address - Country:US
Practice Address - Phone:803-602-4369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074590-11041C0700X
FLTPIC481041C0700X
SC157701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical