Provider Demographics
NPI:1457590937
Name:GUILFOYLE, DEBORAH E (LISW-CP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:GUILFOYLE
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 1:815 JOHN B WHITE SR BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-4039
Mailing Address - Country:US
Mailing Address - Phone:864-310-6776
Mailing Address - Fax:864-310-6777
Practice Address - Street 1:815 JOHN B WHITE SR BLVD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-4039
Practice Address - Country:US
Practice Address - Phone:864-310-6776
Practice Address - Fax:864-310-6777
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC68291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSW1122Medicaid
SC3333Medicare PIN