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Organization

MIDLANDS PSYCHIATRIC SERVICE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELLIE BRYAN MOZINGO M.D. (MANAGING PARTNER)
(803) 779-3548
Entity
Organization

Contact information

Practice address
125 ALPINE CIR, COLUMBIA, SC 29223-6385
(803) 779-3548
(803) 779-7055
Mailing address
125 ALPINE CIR, COLUMBIA, SC 29223-6385
(803) 779-3548
(803) 779-7055

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
103TP0016X
Prescribing (Medical) Psychologist
104100000X
Social Worker

Other

Enumeration date
05/21/2007
Last updated
09/11/2025
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