PROVIDENCE BEHAVIORAL HEALTH SERVICES (NPI# 1801340799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801340799 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE BEHAVIORAL HEALTH SERVICES |
| Other Organization Name | BLACKSTONE |
| Practice Address |
5266 Old Highway 11 Ste 50 Hattiesburg MS 39402-7818 |
| Mailing Address |
5737 Old National Hwy Ste 300 Atlanta GA 30349-3865 |
| Practice Telephone | 6788347615 |
| Mailing Telephone | 6788347615 |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |
| Authorized Official Name | MRS. NIKKI KWONA WRIGHT (DIRECTOR) |
| Authorized Official Telephone | 6788347615 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Blackstone | Other Name - Individual/Organization |
| Street Address |
5266 OLD HIGHWAY 11 STE 50 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-7818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801362264 | Solution Journey Counseling, LLC | Community/Behavioral Health | 301 Humble Ave Ste 160, Hattiesburg, MS 39401-6343 | 2018-10-23 |
| 1982080388 | Golden Angels Adult Daycare, LLC | Community/Behavioral Health | 199 Mary Magdalene Rd, Hattiesburg, MS 39401-8435 | 2015-08-07 |
| 1255723854 | Deborah Ducksworth-williams | Community/Behavioral Health | 2000 W 4th St, Hattiesburg, MS 39401-4753 | 2015-02-19 |
| 1528457801 | His Global Kingdom Inc | Community/Behavioral Health | 607 Corinne St, C3, Hattiesburg, MS 39401-3831 | 2015-01-09 |
| 1013287390 | Albert William Eike | Community/Behavioral Health | 6130 Highway 49, Hattiesburg, MS 39401-7300 | 2012-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738618 | 360inc. | Community/Behavioral Health | 8547 Highway 178, Byhalia, MS 38611-9670 | 2020-10-18 |
| 1407469141 | Life Seasons Counseling, LLC | Community/Behavioral Health | 116 N Columbia St, Pontotoc, MS 38863-2002 | 2020-08-24 |
| 1255959888 | Empowering Minds Counseling and Consultant Services,llc | Community/Behavioral Health | 1114 Robinson St # A, Ocean Springs, MS 39564-3842 | 2020-07-09 |
| 1194349795 | Creative Sisters Counseling LLC | Community/Behavioral Health | 134 Fairmont St Ste C, Clinton, MS 39056-4739 | 2020-05-31 |
| 1386272094 | Mississippi Behavioral Health Care, LLC | Community/Behavioral Health | 1312 Harrison Ave Ste C, Mccomb, MS 39648-2805 | 2020-03-29 |
| 1538703053 | Quest Fitness | Community/Behavioral Health | 1693 Lakeover Rd, Jackson, MS 39213-8015 | 2019-10-29 |
| 1265080576 | Health Connect America, Inc | Community/Behavioral Health | 104 Highway 15 N, New Albany, MS 38652-5313 | 2019-08-29 |
| 1326502535 | V.k. Johnson, Lcsw & Consultants, LLC | Community/Behavioral Health | 2637 Ridgewood Rd Ste De, Jackson, MS 39216-4922 | 2019-01-22 |
| 1316412646 | Delta Counseling Services LLC | Community/Behavioral Health | 103 S Court St Ste 116, Cleveland, MS 38732-2651 | 2018-10-13 |
| 1194211128 | Valerie Freeman | Community/Behavioral Health | 2855 Highway 80 E, Pearl, MS 39208-3408 | 2018-07-02 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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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.