Mustang Medicine Works, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5933 Issued in SC

Legal business name

MUSTANG MEDICINE WORKS, LLC

Practice address

5642 Moorefield Memorial Hwy.
Liberty, SC 29657

Phone

(864) 508-0781

NPI assigned

Aug 27, 2014

Organization subpart

No

Name

Dr. Darrell Gene Yardley, PH.D., LPC

Title

Director

Phone

(864) 508-0781

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Pollock Henry, LPC-I

  • Professional Counselor
  • Liberty, SC
  • NPI 1366825002

  Professional

  NPD (past)

Tax ID family

Mustang Medicine Works LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mustang Medicine Works, LLC

  • Professional Counselor
  • Liberty, SC
  • NPI 1396127056
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 27, 2014.

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1124428016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702",
            "city": "LIBERTY",
            "state": "SC",
            "postal_code": "296570702",
            "telephone_number": "864-508-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5642 MOOREFIELD MEMORIAL HWY.",
            "city": "LIBERTY",
            "state": "SC",
            "postal_code": "29657",
            "telephone_number": "864-508-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTANG MEDICINE WORKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "YARDLEY",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "864-508-0781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Dental Care, Inc.
• Liberty Family Care
• Karen Kidd Middleton, MCD, CCC-SLP
• Kathryn Juanita Morrow, NP
• Cathy Alvarez Murdaugh, PHARMD
• Mustang Medicine Works, LLC
• Michael Nanni, PHARMD
• Beverly Yvonne Nelson
• Jack Edward Newsome Jr., D.C.
• Palmetto Health

• All providers in Liberty, SC
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.