| Sw Ms Mental Health Mental Retardation Commission | |
|
1701 White St Mccomb MS 39648 | |
| (601) 684-2173 | |
| (601) 249-4234 |
| Full Name | Sw Ms Mental Health Mental Retardation Commission |
|---|---|
| Speciality | Clinic/Center |
| Location | 1701 White St, Mccomb, Mississippi |
| Authorized Official Name and Position | Montavia Dorsey (CREDENTIALING MGR) |
| Authorized Official Contact | 6012494235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sw Ms Mental Health Mental Retardation Commission Po Box 768 1701 White St Mccomb MS 39649 Ph: (601) 684-2173 | Sw Ms Mental Health Mental Retardation Commission 1701 White St Mccomb MS 39648 Ph: (601) 684-2173 |
| NPI Number | 1184662694 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 04/06/2023 |
| Certification Date | 04/06/2023 |
| Medicare PECOS PAC ID | 0446205108 |
|---|---|
| Medicare Enrollment ID | O20050315000740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184662694 | NPI | - | NPPES |
| 00018211 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Charlene D King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104851161 PECOS PAC ID: 6901861574 Enrollment ID: I20041123000198 |
| Provider Name | Melissa F Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942256300 PECOS PAC ID: 0143257436 Enrollment ID: I20050719000309 |
| Provider Name | Abby D Mcneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487672283 PECOS PAC ID: 5991709982 Enrollment ID: I20060906000071 |
| Provider Name | Jane Funderburg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487899076 PECOS PAC ID: 3971668500 Enrollment ID: I20090216000313 |
| Provider Name | Donna Kay Pittman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205915428 PECOS PAC ID: 3072641430 Enrollment ID: I20100506000170 |
| Provider Name | Timothy Summers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073684940 PECOS PAC ID: 4082881651 Enrollment ID: I20120123000369 |
| Provider Name | Karen L Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336237833 PECOS PAC ID: 5991857682 Enrollment ID: I20130411000025 |
| Provider Name | Bridget Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154522456 PECOS PAC ID: 1153559356 Enrollment ID: I20140115001398 |
| Provider Name | Mary Allison Heath Sutton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316336993 PECOS PAC ID: 5890011308 Enrollment ID: I20150227001046 |
| Provider Name | Janelle R Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134150006 PECOS PAC ID: 2062577083 Enrollment ID: I20150304001611 |
| Provider Name | Christa L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215416250 PECOS PAC ID: 5991040321 Enrollment ID: I20181213000180 |
| Provider Name | Ursula Brooks-clemons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558727560 PECOS PAC ID: 2365748670 Enrollment ID: I20190528000223 |
| Provider Name | Mark J Mcneil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780050765 PECOS PAC ID: 9032520093 Enrollment ID: I20201123001873 |
| Provider Name | Cynthia C Dukes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912565219 PECOS PAC ID: 0749680619 Enrollment ID: I20210615000089 |
| Provider Name | Heather Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912665985 PECOS PAC ID: 1759773583 Enrollment ID: I20220127002585 |
| Provider Name | Laterra Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417608985 PECOS PAC ID: 6406240308 Enrollment ID: I20220217002879 |
| Provider Name | Saketa Mcentee Polk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205540804 PECOS PAC ID: 0446624449 Enrollment ID: I20230314001895 |
| Provider Name | Jerry R Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679292916 PECOS PAC ID: 2668847385 Enrollment ID: I20230412000346 |
Drlullaby, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1102a Delaware Ave, Mccomb, MS 39648 Phone: 844-475-3379 | |
Mccomb Neurology, Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 N Broadway, 2nd Floor, Mccomb, MS 39648 Phone: 601-249-2491 Fax: 601-249-2885 | |
Pathways Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1301b Harrison Ave, Mccomb, MS 39648 Phone: 601-600-2429 Fax: 601-600-2428 | |
Chris M Huff Lcsw Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 420 Delaware Ave, Mccomb, MS 39648 Phone: 601-209-6345 Fax: 601-835-3342 | |
Stephanie Spears, Lcsw, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Rawls Dr Ste 900, Mccomb, MS 39648 Phone: 601-730-4401 | |
Mccomb School District Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Elmwood St, Mccomb, MS 39648 Phone: 601-249-5138 |