Provider Demographics
NPI:1770241366
Name:HERNDON, YVONNE S (LISW-CP)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:S
Last Name:HERNDON
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 1:8683 BELLS HWY
Mailing Address - Street 2:
Mailing Address - City:RUFFIN
Mailing Address - State:SC
Mailing Address - Zip Code:29475-3534
Mailing Address - Country:US
Mailing Address - Phone:843-909-9777
Mailing Address - Fax:
Practice Address - Street 1:103B HARTH PL
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8107
Practice Address - Country:US
Practice Address - Phone:843-879-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC178461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical