| Midland Valley Behavioral Health & Consulting, Llc | |
|
3524 Jefferson Davis Hwy Graniteville SC 29829 | |
| (803) 380-9004 | |
| (803) 369-3240 |
| Full Name | Midland Valley Behavioral Health & Consulting, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3524 Jefferson Davis Hwy, Graniteville, South Carolina |
| Authorized Official Name and Position | Jay Earles (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8033809004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midland Valley Behavioral Health & Consulting, Llc 388 Bridle Path Rd North Augusta SC 29860-9085 Ph: (803) 640-5101 | Midland Valley Behavioral Health & Consulting, Llc 3524 Jefferson Davis Hwy Graniteville SC 29829 Ph: (803) 380-9004 |
| NPI Number | 1770146540 |
|---|---|
| Provider Enumeration Date | 04/17/2019 |
| Last Update Date | 04/17/2019 |
| Medicare PECOS PAC ID | 9234462342 |
|---|---|
| Medicare Enrollment ID | O20190605000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770146540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jay E Earles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770632515 PECOS PAC ID: 0143553255 Enrollment ID: I20190605002328 |
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