Provider Demographics
NPI:1053749176
Name:BLANDING, THANDI (LISW-CP)
Entity type:Individual
Prefix:MS
First Name:THANDI
Middle Name:
Last Name:BLANDING
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 1:4565 CAMDEN HWY
Mailing Address - Street 2:
Mailing Address - City:DALZELL
Mailing Address - State:SC
Mailing Address - Zip Code:29040-9336
Mailing Address - Country:US
Mailing Address - Phone:803-607-5024
Mailing Address - Fax:
Practice Address - Street 1:4565 CAMDEN HWY
Practice Address - Street 2:
Practice Address - City:DALZELL
Practice Address - State:SC
Practice Address - Zip Code:29040-9336
Practice Address - Country:US
Practice Address - Phone:803-607-5024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC97711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical