Provider Demographics
NPI:1033511837
Name:SCRUGGS, EMILEE (LISW-CP)
Entity type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:
Last Name:SCRUGGS
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 1:880 S PLEASANTBURG DR STE 4F
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2453
Mailing Address - Country:US
Mailing Address - Phone:864-376-6634
Mailing Address - Fax:
Practice Address - Street 1:880 S PLEASANTBURG DR STE 4F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2453
Practice Address - Country:US
Practice Address - Phone:864-376-6634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9442104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker