NPIMap

Organization Active NPI

Midlands Counseling & Consulting Center , LLC

  • Intellectual & Developmental Disabilities Psychologist
  • Columbia, SC
National Provider Identifier
1659529717
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
WP9902 Issued in SC
Legal business name
MIDLANDS COUNSELING & CONSULTING CENTER , LLC
Practice address
2611 Forest Dr Ste 114a
Columbia, SC 29204-2372
Phone
(803) 799-0144
Fax
(803) 799-1136
NPI assigned
Sep 3, 2008
Last updated
Sep 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Mr. Jerome Prezzy, MASTERS ARTNPI 1538206735
Title
Director of Operations
Phone
(803) 799-0144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X WP9902 SC Primary

Addresses

Primary practice location

2611 Forest Dr Ste 114a
Columbia, SC 29204-2372

Mailing address

2611 Forest Dr Ste 114a
Columbia, SC 29204-2372
Phone (803) 799-0144

National Provider Directory

National Provider Directory

Locations

2611 Forest Dr
Ste 114A
Columbia, SC 29204
Phone (803) 463-4910

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1659529717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 114A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042372",
            "telephone_number": "803-799-0144",
            "fax_number": "803-799-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 114A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042372",
            "telephone_number": "803-799-0144",
            "fax_number": "803-799-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLANDS COUNSELING & CONSULTING CENTER , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "PREZZY",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "803-799-0144",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTERS ART"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "SC",
            "license": "WP9902",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 3, 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.