MRS. STEPHANIE ANNE HATHORN (NPI# 1457799199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457799199 |
| Entity Type | Individual |
| Full Name | MRS. STEPHANIE ANNE HATHORN |
| Practice Address |
5422 Clinton Blvd Jackson MS 39209-3004 |
| Mailing Address |
Po Box 3041 Ridgeland MS 39158-3041 |
| Practice Telephone | 6017245040 |
| Mailing Telephone | 6017245040 |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | T0465A | MS | Behavioral Health & Social Service Providers |
| Street Address |
5422 CLINTON BLVD |
| City | JACKSON |
| State | MS |
| Zip Code | 39209-3004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194897140 | Barbara Boss Martin | Counselor | 5422 Clinton Blvd, Jackson, MS 39209 | 2006-11-14 |
| 1477960300 | Dea Dixon Dean | Marriage & Family Therapist | 5422 Clinton Blvd, Jackson, MS 39209-3004 | 2014-07-11 |
| 1902230337 | Rebecca Allison Atwood Jeffries | Counselor | 5422 Clinton Blvd, Jackson, MS 39209-3004 | 2013-08-21 |
| 1063776920 | Michael Hillerman | Counselor | 5422 Clinton Blvd, Jackson, MS 39209-3004 | 2012-06-26 |
| 1366706210 | Hopewell Counseling | Marriage & Family Therapist | 5422 Clinton Blvd, Jackson, MS 39209-3004 | 2012-06-26 |
| 1659587137 | James Bassett Hurley | Marriage & Family Therapist | 5422 Clinton Blvd, Jackson, MS 39209-3004 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| Find all providers in zip 39209 | ||||
| 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 |
| 1043734080 | Naomi Fortune Muffuletto | Marriage & Family Therapist | 1151 North State Street, Suite 212, Jackson, MS 39202-2467 | 2017-08-01 |
| 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 |
| 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.