CREEKSIDE CENTER FOR DEPRESSION AND TMS (NPI# 1356617401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356617401 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE CENTER FOR DEPRESSION AND TMS |
| Practice Address |
174 Murray Guard Dr Suite B Jackson TN 38305-3742 |
| Practice Telephone | 7316600199 |
| Practice Fax Number | 7316603650 |
| Mailing Telephone | 7316600199 |
| Mailing Fax Number | 7316603650 |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |
| Authorized Official Name | DR. PEPPER B PRATT (PARTNER) |
| Authorized Official Telephone | 7316600199 |
| Authorized Official Credential | PH.D., LPC, MHSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
174 MURRAY GUARD DR SUITE B |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-3742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033118633 | Kelvin Wren | Preventive Medicine | 174 Murray Guard Dr, Suite D, Jackson, TN 38305-3742 | 2005-07-18 |
| 1437750791 | Deborah Ann Bellinghausen | Social Worker | 174 Murray Guard Dr, Jackson, TN 38305-3742 | 2020-11-03 |
| 1710597307 | Laura Freeman | Marriage & Family Therapist | 174 Murray Guard Dr, Jackson, TN 38305-3742 | 2020-08-07 |
| 1295363182 | The Pratt Clinic, Inc. | Clinic/Center | 174 Murray Guard Dr, Jackson, TN 38305-3742 | 2020-03-28 |
| 1952629198 | Lifeworks Behavioral Health Inc | Clinical Nurse Specialist | 174 Murray Guard Dr, Suite B, Jackson, TN 38305-3742 | 2010-05-12 |
| 1326215070 | Michelle Dawn Hickerson | Nurse Practitioner | 174 Murray Guard Dr, Suite A, Jackson, TN 38305-3742 | 2008-05-13 |
| 1710104146 | Perry B Pratt | Counselor | 174 Murray Guard Dr, Suite B, Jackson, TN 38305-3742 | 2007-04-19 |
| 1043358617 | Occutran Treatment Center, Plc | Preventive Medicine | 174 Murray Guard Dr, Suite D, Jackson, TN 38305-3742 | 2007-02-03 |
| 1588759500 | Jackson Pulmonary Care, Pa | Internal Medicine | 174 Murray Guard Dr, Suite A, Jackson, TN 38305-3742 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871932194 | Saurabh Bipin Bhardwaj | Psychiatry & Neurology | 2500 N State St # H814, Jackson, MS 39216-4500 | 2013-06-19 |
| 1548421795 | Edgar Draper | Psychiatry & Neurology | 2419 Lake Circle, Jackson, MS 39211 | 2008-06-20 |
| 1689854523 | Robert J Brock Md PC | Psychiatry & Neurology | 480 S Cache, Jackson, WY 83001-0941 | 2007-11-08 |
| 1821285610 | Michaela Puno Weller | Psychiatry & Neurology | 3855 Cooper St, Charles Egeler Reception & Guidance Center, Jackson, MI 49201-7547 | 2007-09-26 |
| 1285846774 | Debra E Rodgers Md Pa | Psychiatry & Neurology | 175 Olympia Flds, Jackson, MS 39211-2510 | 2007-05-04 |
| 1497808463 | Virginia J Payne | Psychiatry & Neurology | 1675 Lakeland Dr Ste 200, Jackson, MS 39216-4843 | 2007-01-20 |
| 1952453854 | Marcelita A Bermudez | Psychiatry & Neurology | 4502 Hwy 951, Jackson, LA 70748 | 2007-01-18 |
| 1225180938 | Joe C Scoggin Sr. | Psychiatry & Neurology | 1675 Lakeland Drive, 200 Riverhill Tower, Jackson, MS 39216-4852 | 2007-01-16 |
| 1649352337 | Michael E Stept | Psychiatry & Neurology | 1675 Lakeland Dr, Ste 200, Jackson, MS 39216-4843 | 2006-10-20 |
| 1881702710 | Andrew Charles Bishop | Psychiatry & Neurology | 971 Lakeland Dr Ste 654, Jackson, MS 39216-4605 | 2006-08-29 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.