Provider Demographics
NPI:1699261743
Name:SINGH, NINA G
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:G
Last Name:SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MAXWELL AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2641
Mailing Address - Country:US
Mailing Address - Phone:864-495-3131
Mailing Address - Fax:
Practice Address - Street 1:104 MAXWELL AVE STE 208
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2641
Practice Address - Country:US
Practice Address - Phone:864-495-3131
Practice Address - Fax:864-495-3132
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7724101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC2402Medicaid
SC3335OtherMEDICARE