NPIMap

Organization Active NPI

Mangum Behavioral Associates, PA

  • Clinical Social Worker
  • Greenville, SC
National Provider Identifier
1861607574
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006453 Issued in SC
Legal business name
MANGUM BEHAVIORAL ASSOCIATES, PA
Practice address
7C Cleveland CT
Greenville, SC 29607-2414
Phone
(864) 360-4341
Fax
(864) 239-6968
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Authorized official

Name
Mr. Harrison Mangum Kisner, MSW, LISW-CPNPI 1063437952
Title
Owner
Phone
(864) 360-4341

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 006453 SC Primary

Addresses

Primary practice location

7C Cleveland CT
Greenville, SC 29607-2414

Mailing address

7C Cleveland CT
Greenville, SC 29607-2414
Phone (864) 360-4341

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248652800000",
    "number": "1861607574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7C CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-360-4341",
            "fax_number": "864-239-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7C CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-360-4341",
            "fax_number": "864-239-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGUM BEHAVIORAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2009-07-27",
        "status": "A",
        "authorized_official_last_name": "KISNER",
        "authorized_official_first_name": "HARRISON",
        "authorized_official_middle_name": "MANGUM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-360-4341",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "006453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.