MDB BEHAVIORAL HEALTH SERVICES LLC (NPI# 1669835310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669835310 |
| Entity Type | Organization |
| Organization Name | MDB BEHAVIORAL HEALTH SERVICES LLC |
| Practice Address |
501 Avalon Way Ste D Brandon MS 39047-7500 |
| Practice Telephone | 6016654162 |
| Practice Fax Number | 8558303484 |
| Mailing Telephone | 6016654162 |
| Mailing Fax Number | 6013624061 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2019-08-01 |
| Authorized Official Name | CHRISTOPHER J WATKINS (MEMBER) |
| Authorized Official Telephone | 6019519863 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07877558 | 05 |
| Street Address |
501 AVALON WAY STE D |
| City | BRANDON |
| State | MS |
| Zip Code | 39047-7500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598773897 | Christopher J Watkins | Nurse Practitioner | 501 Avalon Way Ste D, Brandon, MS 39047-7500 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368783 | Siyuan Chen Kennedy | Counselor | 108 Sandstone Drive, Brandon, MS 39047 | 2020-05-20 |
| 1568019784 | Juarez Brown Emerson | Registered Nurse | 426 Pinebrook Circle, Brandon, MS 39047 | 2019-08-22 |
| 1649764127 | Specialty Diagnostics LLC | Family Medicine | 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 | 2018-06-19 |
| 1528423035 | Kathlene Strangeman | Social Worker | 111 Lakeshore Dr Apt G403, Brandon, MS 39047 | 2015-12-28 |
| 1174935076 | Anthony Davis | Counselor | 198 Bellegrove Cir, Brandon, MS 39047 | 2014-05-27 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1437429941 | Picton Timothy Evans | Pharmacist | 150 B Cumberland Ed, Brandon, MS 39047 | 2012-01-01 |
| 1275828030 | Kathryn Audell Piburn | Nurse Practitioner | 1887 Spillway Rd Ste 140, Brandon, MS 39047 | 2011-06-09 |
| 1801930532 | Susanne Reynolds Moore | Dentist | 1149 Old Fannin Rd, Suite 26, Brandon, MS 39047 | 2007-02-16 |
| 1194898429 | Brookshire Grocery Company | Durable Medical Equipment & Medical Supplies | 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 | 2006-11-16 |
| Find all providers in zip 39047 | ||||
| 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 |
|---|---|---|---|---|
| 1942729736 | Ckmt Enterprises, LLC | Psychiatry & Neurology | 1119 Nikki View Dr, Brandon, FL 33511-4879 | 2017-09-13 |
| 1447644836 | Miriandra De Jesus Rivera | Psychiatry & Neurology | 615 Oakfield Dr, Brandon, FL 33511 | 2015-03-24 |
| 1336376953 | Holly Marie Kinget | Psychiatry & Neurology | 609 Bauxite Cv, Brandon, MS 39047-6509 | 2009-06-22 |
| 1982847083 | Psychiatric Care Center LLC | Psychiatry & Neurology | 342 E Bloomingdale Ave, Brandon, FL 33511-8155 | 2009-04-20 |
| 1891916177 | Walterine Herrington Bell | Psychiatry & Neurology | 548 Highway 468, Brandon, MS 39042-7900 | 2007-05-02 |
| 1528132149 | Rws Psychiatric Services Pa | Psychiatry & Neurology | 576 Bethel Rd, Brandon, MS 39042-7307 | 2006-11-17 |
| 1144394800 | Adrianus J Deruijter | Psychiatry & Neurology | 1427 Oakfield Dr, Brandon, FL 33511-2801 | 2006-11-17 |
| 1629162615 | Boris Kawliche | Psychiatry & Neurology | 407 N Parsons Ave Ste 104, Brandon, FL 33510-4537 | 2006-10-03 |
| 1013014737 | Hany Botros Mikhail | Psychiatry & Neurology | 106 W Windhorst Rd, Brandon, FL 33510-2455 | 2006-09-17 |
| 1730114117 | Eric Jermaine Warren | Psychiatry & Neurology | 613 Marquette Rd, Brandon, MS 39042-3038 | 2006-07-12 |
| Find all providers in BRANDON | ||||
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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.