Nicholas Bagnell, PSYD
Individual provider Active NPI Clinical Psychologist · Columbia, SC
NPI 1497074934 · NPPES record last updated Oct 17, 2023
Key facts
- NPI
- 1497074934
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1548 (SC)
- Practice address
- 1331 Elmwood Ave Ste 300B
Columbia, SC 29201-2150 - Phone
- (803) 250-5109
- NPI assigned
- May 24, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1548 | SC | MD | General Practice Dentistry |
| 29771 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Psychological Services | Mental Health | Current | Accepting new patients |
| Midlands Behavioral Health | Current | Accepting new patients |
Locations
1331 Elmwood Ave
Ste 300
Columbia, SC 29201
Phone (803) 250-5109
1331 Elmwood Ave
Ste 300B
Columbia, SC 29201
Phone (803) 250-5109
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1548 | SC | Yes |
Addresses
Primary practice location
1331 Elmwood Ave Ste 300B
Columbia, SC 29201-2150
Mailing address
1331 Elmwood Ave Ste 300B
Columbia, SC 29201-2150
Phone (803) 250-5109
Other practice location 1
2100 Napa Vallejo Hwy
Napa, CA 94558-6293
Phone (707) 253-5000
Other practice location 2
6024 Robinwood Rd
Columbia, SC 29206-4358
Phone (803) 250-5109
Other providers in Columbia, SC
- Sharon Baechtold
- David Baehren
- Bagga Optometry LLC
- Teresa N Baggett
- Carolane Bagnal
- Amy Bagwell
- Adam J Baier
- Kathryn Marie Bailes
- Bailey B LMT, LLC
- Lydia Celestine Bailey-Padgett
All providers in Columbia, SC · Clinical Psychologist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.