| Delta Autumn Consulting, Llc | |
|
101 Ricky D Britt Sr Blvd Suite 1-b Oxford MS 38655-9103 | |
| (662) 259-0868 | |
| Not Available |
| Full Name | Delta Autumn Consulting, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 101 Ricky D Britt Sr Blvd, Oxford, Mississippi |
| Authorized Official Name and Position | Danielle Maack (CEO/CO-OWNER) |
| Authorized Official Contact | 7696108991 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Autumn Consulting, Llc 101 Ricky D Britt Sr Blvd Suite 1-b Oxford MS 38655-9103 Ph: (662) 259-0868 | Delta Autumn Consulting, Llc 101 Ricky D Britt Sr Blvd Suite 1-b Oxford MS 38655-9103 Ph: (662) 259-0868 |
| NPI Number | 1811288533 |
|---|---|
| Provider Enumeration Date | 04/28/2011 |
| Last Update Date | 06/17/2011 |
| Medicare PECOS PAC ID | 0042480410 |
|---|---|
| Medicare Enrollment ID | O20110823000750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811288533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | John Young |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225324163 PECOS PAC ID: 5597935965 Enrollment ID: I20110823000770 |
| Provider Name | Danielle Maack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033492913 PECOS PAC ID: 4688844053 Enrollment ID: I20111208000257 |
| Provider Name | Anna Katherine Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841674421 PECOS PAC ID: 7517393697 Enrollment ID: I20200210000451 |
| Provider Name | Brittany Spence Sapp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265823181 PECOS PAC ID: 7012387467 Enrollment ID: I20221230000860 |
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