| Behavioral Diagnostics, Llc | |
|
108 Stagecoach Ln Orangeburg SC 29118-2499 | |
| (843) 509-6819 | |
| (803) 496-7237 |
| Full Name | Behavioral Diagnostics, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 108 Stagecoach Ln, Orangeburg, South Carolina |
| Authorized Official Name and Position | James Howard Way (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8435096819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Diagnostics, Llc Po Box 1481 Holly Hill SC 29059-1481 Ph: (843) 509-6819 | Behavioral Diagnostics, Llc 108 Stagecoach Ln Orangeburg SC 29118-2499 Ph: (843) 509-6819 |
| NPI Number | 1992063275 |
|---|---|
| Provider Enumeration Date | 04/24/2012 |
| Last Update Date | 04/24/2012 |
| Medicare PECOS PAC ID | 8123275575 |
|---|---|
| Medicare Enrollment ID | O20120821000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992063275 | NPI | - | NPPES |
| PS0082 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 447 (South Carolina) | Primary |
| Provider Name | James H Way |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073529848 PECOS PAC ID: 9436137684 Enrollment ID: I20090126000534 |
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