MRS. NAOMI FORTUNE MUFFULETTO (NPI# 1043734080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043734080 |
| Entity Type | Individual |
| Full Name | MRS. NAOMI FORTUNE MUFFULETTO |
| Practice Address |
1151 North State Street Suite 212 Jackson MS 39202-2467 |
| Mailing Address |
214 Timberland Ter Madison MS 39110-7196 |
| Practice Telephone | 6013527398 |
| Mailing Telephone | 6019067638 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 2055 | MS | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 408 Fontaine Place, Ridgeland, MS 39157 | 6019913080 |
| Street Address |
1151 NORTH STATE STREET SUITE 212 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700341914 | Heidi Christine Somers | Marriage & Family Therapist | 330 N Glenwood St, Jackson, WY 83001-8765 | 2019-02-01 |
| 1104299791 | Ashlie Edwards Counseling | Marriage & Family Therapist | 91 Stonebridge Blvd Ste 104, Jackson, TN 38305-2042 | 2015-11-04 |
| 1295114361 | Gladys Felicia Dinkins | Marriage & Family Therapist | 5360 Bld. C, Jackson, MS 39206-4101 | 2015-05-22 |
| 1871909689 | Revelation of Hope Counseling Services, LLC | Marriage & Family Therapist | 386 Carriage House Dr Ste B, Jackson, TN 38305-2236 | 2014-07-02 |
| 1003233008 | Leanne Braddock | Marriage & Family Therapist | 561 E Main St, Jackson, TN 38301-6451 | 2014-03-27 |
| 1326388307 | Susan Woodard | Marriage & Family Therapist | 1801 Crane Ridge Dr Ste A, Jackson, MS 39216-4902 | 2013-02-27 |
| 1629362124 | Bradley Bonnett | Marriage & Family Therapist | 401 West St Ste 115, Jackson, MN 56143-1219 | 2011-06-02 |
| 1235438235 | Kathleen Marie Pignataro | Marriage & Family Therapist | 235 New York Ranch Rd Ste C, Jackson, CA 95642-2173 | 2011-03-17 |
| 1629306303 | Lauraq Elise Santomauro | Marriage & Family Therapist | 460 South Jackson Ave., Jackson, WY 83001 | 2009-11-18 |
| 1164757985 | Sharon T. Walls | Marriage & Family Therapist | 480 S. Cache Street, Jackson, WY 83001 | 2009-10-13 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.