MIDSOUTH BEHAVIOR CLINIC


Address: 12482 Magnolia Bend Dr, Arlington, TN 38002-7046
Phone: 9014970384

MIDSOUTH BEHAVIOR CLINIC (NPI# 1750751434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750751434
Entity Type Organization
Organization Name MIDSOUTH BEHAVIOR CLINIC
Practice Address 12482 Magnolia Bend Dr
Arlington
TN 38002-7046
Practice Telephone 9014970384
Practice Fax Number 8668236014
Mailing Telephone 9014970384
Mailing Fax Number 8668236014
Enumeration Date 2015-10-06
Last Update Date 2015-10-06
Authorized Official Name MR. BRANDON ELLIS MCCORD (BEHAVIOR ANALYST)
Authorized Official Telephone 9014970384
Authorized Official Credential M.S., BCBA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health Agencies

Other Provider Identifier

State Issuer Identifier Type Code
TN 2500733 05

Office Location

Street Address 12482 MAGNOLIA BEND DR
City ARLINGTON
State TN
Zip Code 38002-7046

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Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033609136 Roderick Duffey Community/Behavioral Health 2123 Ballycastle Dr, Arlington, TX 76017-4512 2018-05-14
1386145548 Center for Theraputic Change Community/Behavioral Health 1101 W Randol Mill Rd, Arlington, TX 76012-2515 2018-02-23
1376083352 Life We Deserve, LLC Community/Behavioral Health 1919 Clarendon Blvd Apt 538, Arlington, VA 22201 2017-02-24
1427507722 Azra Grudic Consulting and Counseling Community/Behavioral Health 3617 186th Pl Ne # 4a, Arlington, WA 98223-7928 2016-09-27
1578018073 Arise Behavioral Health Community/Behavioral Health 1172 W Pioneer Pkwy, Arlington, TX 76013-6367 2016-08-25
1306202411 North Texas Community Initiative, Inc. Community/Behavioral Health 5811 Gloucester Ct, Suite 101, Arlington, TX 76018-2384 2016-01-05
1891168605 Learning and Behavior Community/Behavioral Health 2023 21st St N Apt 25, Arlington, VA 22201-3650 2015-11-03
1700276375 Epiphany Counseling Services Community/Behavioral Health 901 W Bardin Rd Ste 308, Arlington, TX 76017-6029 2015-02-03
1497169643 Precious J and J Counseling and Associates Community/Behavioral Health 1619 W Division St, Suite E, Arlington, TX 76012-3832 2014-06-16
1104254002 Etho Todd Pugh Sr. Community/Behavioral Health 1904 Roselle Ct, Arlington, TX 76018-2590 2013-10-31
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Competitor

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City ARLINGTON
Zip Code 38002

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Dataset Information

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.

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