Desoto Family Counseling Center Pllc, NPI 1912214792
Community/Behavioral Health Agency in Southaven, MS, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1912214792 |
| NPI Entity Type | Organization |
| Provider Name | Desoto Family Counseling Center Pllc |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 8626 Airways Blvd, Southaven, MS, US |
| Provider Mailing Address | 8626 Airways Blvd, Southaven, MS, US, 386712603 |
| Gender | Male |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | LPC-S Anthony Jerome Wood |
| Official Position | OWNER |
| Phone | 662-772-5937 |
Group Taxonomy
| Taxonomy Code | 193200000X |
| Taxonomy Name | 193200000X MULTI-SPECIALTY GROUP |
| Definition | A business group of one or more individual practitioners, who practice with different areas of specialization. |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Community/Behavioral Health Agency |
| Classification | |
| Group | |
| License No. | 1326 |
| License State | MS |
| Description | A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| No | |||||
| No | |||||
| MS | No | ||||
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
No | ||||
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
No | ||||
| No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 02332763 | MS | MEDICAID | 05 |
| 03458834 | MS | MEDICAID | 05 |
| 09250853 | MS | MEDICAID | 05 |
| 04057773 | MS | MEDICAID | 05 |
| 04073099 | MS | MEDICAID | 05 |
| 09485302 | MS | MEDICAID | 05 |
| 1558401521 | MS | MEDICAID | 05 |
| 01128006 | MS | MEDICAID | 05 |
| 03322249 | MS | MEDICAID | 05 |
| 03350341 | MS | MEDICAID | 05 |
| 05103380 | MS | MEDICAID | 05 |
| 05476356 | MS | MEDICAID | 05 |
| 09588552 | MS | MEDICAID | 05 |
| 00432297 | MS | MEDICAID | 05 |
| 01924277 | MS | MEDICAID | 05 |
| 08579847 | MS | MEDICAID | 05 |
Health Information Exchange
| Endpoint Type | Endpoint | Description | Use | Content Type | Affiliation | Location |
|---|---|---|---|---|---|---|
| DIRECT | [email protected] | Credentialing Contact | DIRECT | OTHER | No | 8626 Airways Blvd, Southaven, MS, US |
Other Providers in MS, US
| NPI | Name | Taxonomy | Address |
|---|---|---|---|
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IDD WAIVER SERVICES Debbie Jones Individual |
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IDD WAIVER SERVICES Beverly Johnson Individual |
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934 West Dr |
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IDD WAIVER SERVICES Monolisa Keyes Individual |
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IDD WAIVER SERVICES Felicia Keller Individual |
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IDD WAIVER SERVICES Sharika Jones Individual |
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IDD WAIVER SERVICES Loverta Jones Individual |
5192 Highway 11 N |
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IDD WAIVER SERVICES Tamekia Mckines Individual |
119 Chambliss Dr |
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Mary Fowler Individual |
5192 Highway 11 N |
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IDD WAIVER SERVICES Porosha Gaines Individual |
106 Mize St Apt 26 |
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DNP, APRN, AGACNP-BC Jo'niece Phillips Redmond Individual |
232 Market St |
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IDD WAIVER SERVICES Fraxine Graves Individual |
1110 42nd Ave |
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IDD WAIVER SERVICES Judy Jones Individual |
405 N First St |
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|
IDD WAIVER SERVICES Michael Mcdonald Individual |
41 Bonhomie Rd |
||
|
IDD WAIVER SERVICES Pamela Mcandrews Individual |
106 Mize St Apt 26 |
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