Carolina Neurobehavioral Associates

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

000664 Issued in SC

Legal business name

CAROLINA NEUROBEHAVIORAL ASSOCIATES

Practice address

1504 Heritage LN
Florence, SC 29505-3141

Phone

(843) 413-0303

Fax

(843) 413-0340

NPI assigned

Feb 1, 2011

Organization subpart

No

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

Authorized official

Name

Jesse Michael West, PH.DNPI 1609850825

Title

Owner

Phone

(843) 413-0303

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jesse Michael West, PH.D

  • Clinical Psychologist
  • Hartsville, SC
  • NPI 1609850825
  NPD (past) Authorized official

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1386940872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 HERITAGE LN",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053141",
            "telephone_number": "843-413-0303",
            "fax_number": "843-413-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 HERITAGE LN",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053141",
            "telephone_number": "843-413-0303",
            "fax_number": "843-413-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA NEUROBEHAVIORAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-413-0303",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "SC",
            "license": "000664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609850825",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Health Care, P.a.
• Carolina Home Care, Inc
• Carolina Home Care, LLC
• Carolina Hope and Healing, LLC
• Carolina Medcare
• Carolina Pathways Behavior Health, LLC
• Carolina Pediatric Counseling and Educational Services
• Carolina Podiatry
• Carolina Prudent Group LLC
• Carolina Regional Dental, P.a.

• Clinical Neuropsychologist in Florence, SC
• Providers in Florence, SC by specialty
• Clinical Neuropsychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.