| Mpower Healing, Pllc | |
|
124 Kirkwood St Picayune MS 39466-3866 | |
| (601) 799-9500 | |
| (855) 675-8575 |
| Full Name | Mpower Healing, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 124 Kirkwood St, Picayune, Mississippi |
| Authorized Official Name and Position | Desarae Swilley Rice (OWNER) |
| Authorized Official Contact | 6017999500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mpower Healing, Pllc Po Box 1111 Picayune MS 39466-1111 Ph: (601) 799-9500 | Mpower Healing, Pllc 124 Kirkwood St Picayune MS 39466-3866 Ph: (601) 799-9500 |
| NPI Number | 1811497464 |
|---|---|
| Provider Enumeration Date | 02/20/2018 |
| Last Update Date | 07/07/2022 |
| Certification Date | 07/07/2022 |
| Medicare PECOS PAC ID | 7416205273 |
|---|---|
| Medicare Enrollment ID | O20180810000395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811497464 | NPI | - | NPPES |
| 00584268 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C6956 (Mississippi) | Primary |
| Provider Name | Desarae S Rice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629321344 PECOS PAC ID: 0143578906 Enrollment ID: I20180810000655 |
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