NPIMap

Organization Active NPI

Dutch Fork Psychological Services

  • Clinical Psychologist
  • Irmo, SC
National Provider Identifier
1750308409
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
654 Issued in SC
Legal business name
DUTCH FORK PSYCHOLOGICAL SERVICES
Practice address
7313 College St
Irmo, SC 29063-2902
Phone
(803) 407-7099
Fax
(803) 807-9104
NPI assigned
Jul 17, 2006
Last updated
Apr 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Dr. William E. Haxton, PH.D.NPI 1932126687
Title
Owner
Phone
(803) 407-7099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 654 SC Primary

Addresses

Primary practice location

7313 College St
Irmo, SC 29063-2902

Mailing address

7313 College St
Irmo, SC 29063-2902
Phone (803) 407-7099

National Provider Directory

National Provider Directory

Locations

7313 College St
Irmo, SC 29063
Phone (803) 407-7099

Practitioners & affiliated clinicians

Practitioners 1

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1750308409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7313 COLLEGE ST",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632902",
            "telephone_number": "803-407-7099",
            "fax_number": "803-807-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7313 COLLEGE ST",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632902",
            "telephone_number": "803-407-7099",
            "fax_number": "803-807-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUTCH FORK PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "HAXTON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-407-7099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.