Joseph Patrick Boland, PH.D.
Individual provider Active NPI Clinical Psychologist · Columbia, SC
NPI 1801824701 · NPPES record last updated Aug 26, 2010
Key facts
- NPI
- 1801824701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 442 (SC)
- Practice address
- 1 Harbison Way
Suite 110
Columbia, SC 29212-3422 - Phone
- (803) 781-4265
- Fax
- (803) 781-7300
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1024 Wildewood Centre Dr
Suite a
Columbia, SC 29229-8400
Phone (803) 781-4265
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120420000099 | SC | Practitioner - Clinical Psychologist | 0143481010 | Practice locations: Columbia, SC |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 442 | SC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Assessment & Counseling Services | Current |
Accepting new patients |
Locations
1 Harbison Way
Ste 110
Columbia, SC 29212
Phone (803) 781-4265
1024 Wildwood Centre Dr
Ste A
Columbia, SC 29229
Phone (803) 781-4265
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | AD003091 | ||
| Clinical Psychologist | 103TC0700X | 442 | SC | Yes |
Addresses
Primary practice location
1 Harbison Way
Suite 110
Columbia, SC 29212-3422
Mailing address
1 Harbison Way
Suite 110
Columbia, SC 29212-3422
Phone (803) 781-4265
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 457503000 | Other | MAGELLAN | |
| 177600 | Other | APS HEALTHCARE |
Other providers in Columbia, SC
- Elizabeth Ann Boison
- Jordan Bolan
- Caroline Boland
- Elizabeth Kolb Boland
- Janet Updyke Boland
- Kayla D Boland
- Carrie L. Bolden
- Kelle Danielle Bolden
- Kimberly Curry Bolen
- Diane Bolin
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 Aug 26, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.