Provider Demographics
NPI:1538425426
Name:APPENZELLER, GEORGE WILLIAM (MSW)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:WILLIAM
Last Name:APPENZELLER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 MIDDLEBURG DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2413
Mailing Address - Country:US
Mailing Address - Phone:803-771-6663
Mailing Address - Fax:803-771-1595
Practice Address - Street 1:2711 MIDDLEBURG DR
Practice Address - Street 2:SUITE 301
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2413
Practice Address - Country:US
Practice Address - Phone:803-771-6663
Practice Address - Fax:803-771-1595
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21991041C0700X
NCC0068171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical