DR. BENETRA MANGUM-JOHNSON (NPI# 1528610326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528610326 |
| Entity Type | Individual |
| Full Name | DR. BENETRA MANGUM-JOHNSON |
| Credential | PHD, LCSW |
| Practice Address |
2500 N. State St. Dept. of Psychiatry and Human Behavior (h808) Jackson MS 39216 |
| Mailing Address |
2500 North State Street Cbo - Suite 4200 Jackson MS 39216-4500 |
| Practice Telephone | 6018156337 |
| Mailing Telephone | 6014969794 |
| Mailing Fax Number | 6018150434 |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C7180 | MS | Behavioral Health & Social Service Providers |
| Street Address |
2500 N. STATE ST. DEPT. OF PSYCHIATRY AND HUMAN BEHAVIOR (H808) |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982672309 | Edward E Hill | Dentist | 2500 N. State St., Jackson, MS 39216-4505 | 2006-03-10 |
| 1700415494 | Ritesh Patel | Student in an Organized Health Care Education/Training Program | 2500 N. State St., Jackson, MS 39216 | 2020-04-03 |
| 1841777547 | Mark Henry Nagorka | Student in an Organized Health Care Education/Training Program | 2500 N. State St., Dept of Oral-maxillofacial Surgery and Pathology, Jackson, MS 39216-4505 | 2018-07-25 |
| 1932553229 | Adrienne Paige | Obstetrics & Gynecology | 2500 N. State St., Obstetrics and Gynecology, Jackson, MS 39216 | 2016-04-22 |
| 1669826947 | Summer Bailey | Student in an Organized Health Care Education/Training Program | 2500 N. State St., Obstetrics and Gynecolgoy, Jackson, MS 39216 | 2016-04-22 |
| 1821452947 | Marvell Saint-victor | Student in an Organized Health Care Education/Training Program | 2500 N. State St., Radiology, Jackson, MS 39216 | 2016-04-06 |
| 1760877112 | Lauren Rowe-hobbs | Pediatrics | 2500 N. State St., Pediatrics, Jackson, MS 39216-4409 | 2015-04-02 |
| 1730574187 | Eric Niles Mcdonald | Emergency Medicine | 2500 N. State St., Department of Emergency Medicine, Jackson, MS 39216 | 2015-04-02 |
| 1073928941 | Patricia Garcia Amolenda | Anesthesiology | 2500 N. State St., Department of Anesthesiology, Jackson, MS 39216 | 2014-06-30 |
| 1841602778 | Virginia Wright | Internal Medicine | 2500 N. State St., Department of Internal Medicine, Jackson, MS 39216 | 2014-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518430 | Millie Mitchell | Social Worker | 321 Woodland Dr, Jackson, AL 36545-2438 | 2020-11-03 |
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1760098487 | Dominique Yvette Thomatis-williams | Social Worker | 4 Creekwood Pl, Jackson, MS 39211-2929 | 2020-09-17 |
| 1417567215 | Angela Edward | Social Worker | 413 Seymour Ave, Jackson, MI 49202-3562 | 2020-08-06 |
| 1952926677 | Kayleen Marie Shaw | Social Worker | 4152 County Road 436, Jackson, MO 63755-8411 | 2020-06-09 |
| 1538798327 | Willie Patrice Jenkins | Social Worker | 108 Parks Rd, Jackson, MS 39212-9626 | 2020-04-03 |
| 1184251555 | Yasmeen Patricia Eichelberger | Social Worker | 510 George St, Ste 201, Jackson, MS 39202-3027 | 2020-03-25 |
| 1902431612 | Harriet Phyllis Kazansky | Social Worker | 4 Hazeltine Ln, Jackson, NJ 08527-4045 | 2020-03-03 |
| 1750915229 | Kacey Pepin | Social Worker | 3027 Wildwood Ave, Jackson, MI 49202-3938 | 2020-02-24 |
| 1831729433 | Rachel Kornilakis | Social Worker | 729 W Michigan Ave # 200, Jackson, MI 49201-1920 | 2020-01-22 |
| 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.