Provider Demographics
NPI:1811357007
Name:HASTINGS, ZETA (LISW-CP)
Entity type:Individual
Prefix:MRS
First Name:ZETA
Middle Name:
Last Name:HASTINGS
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 1:206 SPOONBILL CT
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-7334
Mailing Address - Country:US
Mailing Address - Phone:803-446-0084
Mailing Address - Fax:
Practice Address - Street 1:2721 DUTCH FORK RD
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-8565
Practice Address - Country:US
Practice Address - Phone:803-446-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC86241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical