ERIC SUDDEATH (NPI# 1700302007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700302007 |
| Entity Type | Individual |
| Full Name | ERIC SUDDEATH |
| Credential | MA, LPC |
| Practice Address |
304 Enterprise Dr Oxford MS 38655-2762 |
| Mailing Address |
4005 Davis Dr Oxford MS 38655-4279 |
| Practice Telephone | 6623711711 |
| Mailing Telephone | 9016073705 |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2017-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 2201 | MS | Behavioral Health & Social Service Providers |
| Street Address |
304 ENTERPRISE DR |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-2762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770935595 | Oxford Counseling Center, LLC | Counselor | 304 Enterprise Dr, Oxford, MS 38655 | 2016-07-05 |
| 1912485319 | Allison Boyd Layton | Counselor | 304 Enterprise Dr, Oxford, MS 38655-2762 | 2018-07-30 |
| 1962990465 | The Wellness Center of Oxford LLC | Clinic/Center | 304 Enterprise Dr, Oxford, MS 38655-2762 | 2018-04-30 |
| 1275053373 | Kimberly Suddeath | Dietitian, Registered | 304 Enterprise Dr, Oxford, MS 38655-2762 | 2017-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689202178 | Nicole Lynn Yenter | Counselor | 800 Van Buren Ave, Oxford, MS 38655-3844 | 2020-03-30 |
| 1043869092 | Vernitra Lashay Dobbins | Counselor | 439 Sterling Pointe Ln Apt 8, Oxford, AL 36203-2070 | 2019-09-11 |
| 1336594324 | Brenda Wimberly | Counselor | 1209 Ivy Rd Unit 106, Oxford, MS 38655-2886 | 2016-04-27 |
| 1588957245 | Patricia Louise Switaj | Counselor | 583 Southshore Dr, Oxford, MI 48371-3558 | 2011-05-26 |
| 1427210657 | The Gabriel Foundation | Counselor | 5821 Hester Rd, Oxford, OH 45056-1390 | 2008-06-29 |
| 1558545897 | Christopher Jackson | Counselor | 105 Highway 9, Oxford, AR 72565-0096 | 2007-12-21 |
| 1831310937 | Rebecca S Derwin | Counselor | 104 College St, Oxford, NC 27565-2962 | 2007-05-02 |
| 1477609170 | Suzanne Fischer | Counselor | 4734 Sailors Retreat Ct, Oxford, MD 21654-1745 | 2007-01-26 |
| 1588282297 | Alexandra M Gilbert | Counselor | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-07-09 |
| 1083232995 | Mikaela Raley | Counselor | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-07-07 |
| Find all providers in OXFORD | ||||
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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.