CARDINAL CLINICAL CONSULTING, LLC (NPI# 1417514274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417514274 |
| Entity Type | Organization |
| Organization Name | CARDINAL CLINICAL CONSULTING, LLC |
| Practice Address |
2625 Traceland Dr Ste B Tupelo MS 38801-4240 |
| Practice Telephone | 6622693599 |
| Practice Fax Number | 6622592503 |
| Mailing Telephone | 6622693599 |
| Mailing Fax Number | 6622592503 |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |
| Authorized Official Name | MR. JOSHUA C FULWILER (OWNER) |
| Authorized Official Telephone | 6622693599 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
2625 TRACELAND DR STE B |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-4240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841674645 | Joshua Campbell Fulwiler | Psychologist | 2625 Traceland Dr Ste B, Tupelo, MS 38801-4240 | 2015-07-13 |
| 1881248516 | Christian Shannon Courson | Behavior Technician | 2625 Traceland Dr Ste B, Tupelo, MS 38801-4240 | 2019-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841674645 | Joshua Campbell Fulwiler | Psychologist | 2625 Traceland Dr Ste B, Tupelo, MS 38801-4240 | 2015-07-13 |
| 1518133347 | Joyce A. Cole-marion | Psychologist | 320 S Spring St, Tupelo, MS 38804-4822 | 2008-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245883339 | Laura J Dixon | Psychologist | 382 Kinard Hall, Psychological Services Center, University, MS 38677 | 2019-07-18 |
| 1598163321 | Joye W Shanteau | Psychologist | 410 Wulff Dr, None, Ocean Springs, MS 39564-4544 | 2014-12-10 |
| 1205236932 | James A Chaney | Psychologist | 306 Aston Ave, Mccomb, MS 39648-3808 | 2014-08-29 |
| 1558787622 | Shenia Lyons | Psychologist | 665 Highway 51 Ste A, Ridgeland, MS 39157-2136 | 2014-03-12 |
| 1861826927 | Andy Tseng | Psychologist | 400 Veterans Ave (116b), Va Gulf Coast Health Care System, Biloxi, MS 39531 | 2013-08-26 |
| 1215375746 | Payne Behavioral Medicine | Psychologist | 4005 N State St Ste N, Jackson, MS 39206-5755 | 2013-06-06 |
| 1366887135 | Brighter Day Health LLC | Psychologist | 716 Esplanade Dr, Ridgeland, MS 39157-5131 | 2013-05-06 |
| 1811245277 | Amanda L Gugliano | Psychologist | 1490 W Government St, Suite 7, Brandon, MS 39042-3024 | 2012-08-16 |
| 1497027775 | Fitness Clinic | Psychologist | 2219 Greenway Dr, Jackson, MS 39204-3202 | 2012-02-02 |
| 1033492913 | Danielle Maack | Psychologist | 101 Ricky D Britt Sr Blvd Ste 1b, Oxford, MS 38655-9111 | 2011-09-27 |
| Find all providers with the same taxonomy | ||||
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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.