Midland Valley Behavioral Health & Consulting, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MIDLAND VALLEY BEHAVIORAL HEALTH & CONSULTING, LLC

Practice address

3524 Jefferson Davis Hwy
Graniteville, SC 29829

Phone

(803) 380-9004

Fax

(803) 369-3240

NPI assigned

Apr 17, 2019

Last updated

Apr 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay Earles, PSYDNPI 1770632515

Title

Clinical Psychologist

Phone

(803) 380-9004

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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.

• Jay E Earles, PSYD

  • Health Psychologist
  • Aiken, SC
  • NPI 1770632515
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1770146540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 BRIDLE PATH RD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298609085",
            "telephone_number": "803-640-5101",
            "fax_number": "803-369-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 JEFFERSON DAVIS HWY",
            "city": "GRANITEVILLE",
            "state": "SC",
            "postal_code": "29829",
            "telephone_number": "803-380-9004",
            "fax_number": "803-369-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND VALLEY BEHAVIORAL HEALTH & CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "EARLES",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "803-380-9004",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Joachim, DO
• Cassi Dawn Reams Jones, D.O.
• Darrell William Jones, LCSW, BCD
• Love Legacy Care LLC
• Jennifer Rebecca Messina, LMSW
• Koshon Mitchell
• Shatori Moore, REGISTERED NURSE
• Alexa Myers, DDS
• Tyler Reed Myers, DDS
• Angela Odom

• Community/Behavioral Health Agency in Graniteville, SC
• Providers in Graniteville, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.