| Region 8 Mental Health Mental Retardation Commission | |
|
613 Marquette Road Brandon MS 39042 | |
| (601) 824-0342 | |
| (601) 824-0349 |
| Full Name | Region 8 Mental Health Mental Retardation Commission |
|---|---|
| Speciality | Clinic/Center |
| Location | 613 Marquette Road, Brandon, Mississippi |
| Authorized Official Name and Position | Dave Van (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6018240342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Region 8 Mental Health Mental Retardation Commission Po Box 88 Brandon MS 39043 Ph: (601) 824-0342 | Region 8 Mental Health Mental Retardation Commission 613 Marquette Road Brandon MS 39042 Ph: (601) 824-0342 |
| NPI Number | 1063428761 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 06/27/2022 |
| Certification Date | 06/27/2022 |
| Medicare PECOS PAC ID | 4284671181 |
|---|---|
| Medicare Enrollment ID | O20050412001203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063428761 | NPI | - | NPPES |
| 00018208 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | R081 (Mississippi) | Primary |
| Provider Name | Eric Warren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730114117 PECOS PAC ID: 2062484991 Enrollment ID: I20040810001413 |
| Provider Name | William Dwight Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669586996 PECOS PAC ID: 9830136001 Enrollment ID: I20050411000343 |
| Provider Name | Jeffrey Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164468468 PECOS PAC ID: 2163462110 Enrollment ID: I20050509000964 |
| Provider Name | Noel Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225353840 PECOS PAC ID: 7517090665 Enrollment ID: I20100727000466 |
| Provider Name | Natalie W Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740563543 PECOS PAC ID: 7214195593 Enrollment ID: I20120215000617 |
| Provider Name | Tanya Linette Calhoun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053753194 PECOS PAC ID: 3577792597 Enrollment ID: I20140214000525 |
| Provider Name | Jana Paige Cline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083043681 PECOS PAC ID: 0941433155 Enrollment ID: I20140515000771 |
| Provider Name | Shonna P Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699177634 PECOS PAC ID: 5597089482 Enrollment ID: I20150126000125 |
| Provider Name | Koscher Denee Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417350182 PECOS PAC ID: 1052635638 Enrollment ID: I20150130002248 |
| Provider Name | Amy W Easley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720485600 PECOS PAC ID: 6709106479 Enrollment ID: I20150520000920 |
| Provider Name | Mitzi Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356713903 PECOS PAC ID: 1254638422 Enrollment ID: I20160404000309 |
| Provider Name | Rosanna Lea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861876310 PECOS PAC ID: 4486952470 Enrollment ID: I20160407000267 |
| Provider Name | Robert F Maddux |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831319359 PECOS PAC ID: 0244522704 Enrollment ID: I20160705000059 |
| Provider Name | David A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396106456 PECOS PAC ID: 3870876709 Enrollment ID: I20170220000771 |
| Provider Name | Nancy Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871944652 PECOS PAC ID: 3173809605 Enrollment ID: I20170417000713 |
| Provider Name | Maria Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972804474 PECOS PAC ID: 3577837988 Enrollment ID: I20170925000960 |
| Provider Name | Daniel Gerard Jemison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699296509 PECOS PAC ID: 4486911617 Enrollment ID: I20171127001221 |
| Provider Name | Brandy Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013491992 PECOS PAC ID: 0244574820 Enrollment ID: I20181210000090 |
| Provider Name | Mary E Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437795606 PECOS PAC ID: 2264861632 Enrollment ID: I20200406002372 |
| Provider Name | Summer Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831829167 PECOS PAC ID: 6002296837 Enrollment ID: I20220711000591 |
| Provider Name | William Rushing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952083370 PECOS PAC ID: 4082069885 Enrollment ID: I20231014000464 |
Kidz Konnections Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Avalon Way, Apt 313, Brandon, MS 39047 Phone: 404-279-0598 | |
Boudreaux Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 98 Burnham Rd, Suite A, Brandon, MS 39042 Phone: 601-664-0204 | |
Region 8 Mh/mr Commission Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 613 Marquette Road, Brandon, MS 39042 Phone: 601-824-0342 Fax: 601-824-0349 | |
Ebullience Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Avalon Way Ste D, Brandon, MS 39047 Phone: 601-874-3340 Fax: 601-494-3241 | |
Comprehensive Total Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Avalon Cir Ste B, Brandon, MS 39047 Phone: 252-315-5165 | |
New Progressions Of Mississippi, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1490 W Government St Ste 7-263, Brandon, MS 39042 Phone: 336-254-6770 |