Provider Demographics
NPI:1396079927
Name:ZEMP, MADGE W (LPC)
Entity type:Individual
Prefix:
First Name:MADGE
Middle Name:W
Last Name:ZEMP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 BALLENTINE AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-5003
Mailing Address - Country:US
Mailing Address - Phone:843-857-8525
Mailing Address - Fax:
Practice Address - Street 1:5003 UNA RD
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-1954
Practice Address - Country:US
Practice Address - Phone:843-453-9985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional