| Hamiltondavis Mental Health, Inc. | |
|
2508 Lakeland Dr Flowood MS 39232-9502 | |
| (601) 932-8991 | |
| (601) 932-1007 |
| Full Name | Hamiltondavis Mental Health, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2508 Lakeland Dr, Flowood, Mississippi |
| Authorized Official Name and Position | Marie Abston (PRESIDENT) |
| Authorized Official Contact | 6013315908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hamiltondavis Mental Health, Inc. 2508 Lakeland Dr Flowood MS 39232-9502 Ph: (601) 932-1003 | Hamiltondavis Mental Health, Inc. 2508 Lakeland Dr Flowood MS 39232-9502 Ph: (601) 932-8991 |
| NPI Number | 1255977419 |
|---|---|
| Provider Enumeration Date | 11/22/2019 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 2466880117 |
|---|---|
| Medicare Enrollment ID | O20200312000874 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255977419 | NPI | - | NPPES |
| 007282551 | Medicaid | MS | |
| 008055799 | Medicaid | MS | |
| 100118820 | Medicaid | MS | |
| 001736095 | Medicaid | MS |
| Provider Name | Maxie Lerone Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427018613 PECOS PAC ID: 2466406798 Enrollment ID: I20050309000456 |
| Provider Name | Terkita Ford Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609658830 PECOS PAC ID: 2466898036 Enrollment ID: I20240321002060 |
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