| Integrated Health | |
|
5779 Getwell Rd Bldg D3 Southaven MS 38672-6351 | |
| (662) 510-6507 | |
| (662) 510-6508 |
| Full Name | Integrated Health |
|---|---|
| Speciality | Psychologist |
| Location | 5779 Getwell Rd Bldg D3, Southaven, Mississippi |
| Authorized Official Name and Position | Emily Thomas Johnson (OWNER) |
| Authorized Official Contact | 6626094950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Health 4628 Union Rd Sardis MS 38666-3280 Ph: (662) 609-4950 | Integrated Health 5779 Getwell Rd Bldg D3 Southaven MS 38672-6351 Ph: (662) 510-6507 |
| NPI Number | 1902089857 |
|---|---|
| Provider Enumeration Date | 12/14/2007 |
| Last Update Date | 02/22/2021 |
| Certification Date | 02/22/2021 |
| Medicare PECOS PAC ID | 9537597356 |
|---|---|
| Medicare Enrollment ID | O20200310000718 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902089857 | NPI | - | NPPES |
| Q055944 | Medicaid | TN | |
| 00634747 | Medicaid | MS |
| Provider Name | Emily Thomas Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538376199 PECOS PAC ID: 7517036015 Enrollment ID: I20080524000010 |
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