# JARED J CARBONE APRN PMHNP-BC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Om Telepsychiatric Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245091917
- **Authorized official:** JARED JOSHUA CARBONE (OWNER)
- **Authorized official phone:** (864) 477-3447

## Contact information

- **Practice address:** 128 MILLPORT CIR STE 200, GREENVILLE, SC 29607-5573
- **Practice address phone:** (864) 477-3447
- **Practice address fax:** (877) 935-4151
- **Mailing address:** 52 WILLOMERE WAY, SIMPSONVILLE, SC 29681-7136
- **Mailing address phone:** (864) 477-3447
- **Mailing address fax:** (877) 935-4151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2024
- **Last updated:** 03/13/2026