Individual provider Active NPI

Tora L Brawley, PH.D.

  • Forensic Psychologist
  • Columbia, SC
National Provider Identifier
1235190653
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
752 Issued in SC
Practice address
15 Medical Park Rd
Suite 103
Columbia, SC 29203-8003
Phone
(803) 434-4300
Fax
(803) 434-4277
NPI assigned
Mar 28, 2006
Last updated
Dec 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 752 SC
Forensic Psychologist 103TF0200X 752 SC Primary

Addresses

Primary practice location

15 Medical Park Rd
Suite 103
Columbia, SC 29203-8003

Mailing address

15 Medical Park Rd
Suite 103
Columbia, SC 29203-8003
Phone (803) 434-4300

Other identifiers 1

IdentifierTypeStateIssuer
PS0311MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
752SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Specialty Clinics - Neuropsychiatry and Behavioral Science Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1235190653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK RD",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038003",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL PARK RD",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038003",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAWLEY",
        "first_name": "TORA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "752",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "SC",
            "license": "752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0311",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.