| Positive Pathways, Llc | |
|
1110 Clay St Vicksburg MS 39183-2912 | |
| (601) 813-5878 | |
| Not Available |
| Full Name | Positive Pathways, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1110 Clay St, Vicksburg, Mississippi |
| Authorized Official Name and Position | Timeka Sheree Wright (PRESIDENT) |
| Authorized Official Contact | 6018135878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Pathways, Llc 1110 Clay St Vicksburg MS 39183-2912 Ph: (601) 813-5878 | Positive Pathways, Llc 1110 Clay St Vicksburg MS 39183-2912 Ph: (601) 813-5878 |
| NPI Number | 1801335492 |
|---|---|
| Provider Enumeration Date | 02/16/2017 |
| Last Update Date | 10/31/2019 |
| Medicare PECOS PAC ID | 0648678425 |
|---|---|
| Medicare Enrollment ID | O20211021000305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801335492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Donna Kay Pittman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205915428 PECOS PAC ID: 3072641430 Enrollment ID: I20100506000170 |
| Provider Name | Maurice Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558393843 PECOS PAC ID: 7517126360 Enrollment ID: I20120314000215 |
| Provider Name | Joycelyn L Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649879461 PECOS PAC ID: 7517355530 Enrollment ID: I20211025002250 |
| Provider Name | Amanda Brooke Roach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366918195 PECOS PAC ID: 5991193468 Enrollment ID: I20211102003425 |
| Provider Name | Marie Ross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750737839 PECOS PAC ID: 2769822535 Enrollment ID: I20240426000447 |
Warren Yazoo Mental Health Service Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-634-0234 | |
The Peace Place Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 Holly St, Vicksburg, MS 39180 Phone: 601-630-3362 Fax: 855-540-0718 | |
Divine Home Care Changes Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Ethel Dr, Vicksburg, MS 39180 Phone: 919-339-1854 | |
Nulife Healthcare, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Holt Collier Dr Ste C, Vicksburg, MS 39183 Phone: 601-738-5565 Fax: 601-738-5544 | |
Cognitive Development Center Of Mississippi Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1713 Clay St, Vicksburg, MS 39183 Phone: 601-883-1771 Fax: 601-883-1773 | |
Gateway Health Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2705 Clay St, Vicksburg, MS 39183 Phone: 601-661-9752 Fax: 601-661-6021 | |
Nulife Health Care Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 120 Holt Collier Dr Ste C, Vicksburg, MS 39183 Phone: 601-738-5565 Fax: 601-738-5544 |