Organization
MIDLANDS BEHAVIORAL HEALTH
Active
Other names
Southeastern Center for Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
NICK BAGNELL (PRESIDENT)
(803) 250-5108
Entity
Organization
Contact information
Practice address
1331 ELMWOOD AVE STE 300B, COLUMBIA, SC 29201-2150
(803) 250-5108
Mailing address
1331 ELMWOOD AVE STE 300B, COLUMBIA, SC 29201-2150
(803) 250-5108
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
12/20/2023
Last updated
02/16/2024
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