<unavail> in Jackson, MS - Medicare Counselor

is a medicare enrolled mental health clinic (Counselor) in Jackson, Mississippi. The current practice location for is 4500 I 55 N Ste 208, Jackson, Mississippi. For appointments, you can reach them via phone at (601) 292-6260. The mailing address for is Po Box 12195, Jackson, Mississippi and phone number is (601) 292-6260.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1083176218. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (601) 292-6260.

Contact Information


	4500 I 55 N Ste 208 Jackson MS 39211-5931
	(601) 292-6260
	(601) 487-8115

Map and Direction

Mental Health Clinic Profile

Full Name
Speciality	Counselor
Location	4500 I 55 N Ste 208, Jackson, Mississippi
Authorized Official Name and Position	Sherry Bouldin (OWNER)
Authorized Official Contact	6012926260
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 12195 Jackson MS 39236-2195 Ph: (601) 292-6260	4500 I 55 N Ste 208 Jackson MS 39211-5931 Ph: (601) 292-6260

NPI Details:

NPI Number	1083176218
Provider Enumeration Date	04/05/2019
Last Update Date	07/06/2022
Certification Date	07/06/2022

Medicare PECOS Information:

Medicare PECOS PAC ID	8022455427
Medicare Enrollment ID	O20240320004299

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083176218	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	(* (Not Available))	Primary
101YA0400X	Counselor - Addiction (substance Use Disorder)	(* (Not Available))	Secondary
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
101YP2500X	Counselor - Professional	(* (Not Available))	Secondary
102L00000X	Psychoanalyst	(* (Not Available))	Secondary
103K00000X	Behavior Analyst	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Sherry Bouldin
Provider Type	Practitioner - Mental Health Counselor
Provider Identifiers	NPI Number: 1053784918 PECOS PAC ID: 3476986787 Enrollment ID: I20240320004308

Reviews and Comments

Counselor in Jackson, MS

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- Medicare Mental Health Clinic in Jackson, MS