DR. KATTRINA ROACH (NPI# 1568837870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568837870 |
| Entity Type | Individual |
| Full Name | DR. KATTRINA ROACH |
| Credential | PHD |
| Practice Address |
8829 Centre St Southaven MS 38671-2610 |
| Mailing Address |
1622 Montys Cir Southaven MS 38672-8547 |
| Practice Telephone | 6622805758 |
| Practice Fax Number | 6622805708 |
| Mailing Telephone | 6624041134 |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2041 | MS | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
2041 | MS | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2041 | MS | Behavioral Health & Social Service Providers |
| Street Address |
8829 CENTRE ST |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-2610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376633594 | Candace Marie Thompson | Psychiatry & Neurology | 8829 Centre St, Southaven, MS 38671-2610 | 2006-10-16 |
| 1225596174 | Turning Point Counseling and Consulting, LLC. | Counselor | 8829 Centre St, Southaven, MS 38671-2610 | 2019-03-11 |
| 1396288361 | Journeypure Southaven, LLC | Clinic/Center | 8829 Centre St, Southaven, MS 38671-2610 | 2016-11-23 |
| 1780127845 | Journeypure Mississippi Medical Group LLC | Psychologist | 8829 Centre St, Southaven, MS 38671-2610 | 2016-11-22 |
| 1336681584 | Journeypure Southaven, LLC | Clinic/Center | 8829 Centre St, Southaven, MS 38671-2610 | 2016-11-04 |
| 1699083709 | Kelli H. Davis | Counselor | 8829 Centre St, Southaven, MS 38671-2610 | 2010-09-23 |
| 1043541212 | Debbie S. Harrison | Counselor | 8829 Centre St, Southaven, MS 38671-2610 | 2010-01-27 |
| 1376871459 | Beth Hand | Social Worker | 8829 Centre St, Southaven, MS 38671-2610 | 2009-11-30 |
| 1003956194 | George Paul Comeaux | Social Worker | 8829 Centre St, Southaven, MS 38671-2610 | 2007-02-07 |
| 1851461917 | Mattison Lanier Ellis | Counselor | 8829 Centre St, Suite 105, Southaven, MS 38671-2610 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720502032 | Darby Walton | Counselor | 6858 Swinnea Rd Bldg 1b, Southaven, MS 38671-9493 | 2017-07-28 |
| 1255793014 | Dianne Cheah Cox | Counselor | 7145 Swinnea Rd Ste 2, Southaven, MS 38671-6380 | 2016-03-22 |
| 1861882409 | Mary Fox | Counselor | 975 Swinnea Rdg, Suite 3, Southaven, MS 38671-6013 | 2015-02-04 |
| 1811309222 | Melba Elissa Brown | Counselor | 7688 Rowan Ln Apt 8, Southaven, MS 38671-6700 | 2014-05-20 |
| 1316181365 | Claycon LLC | Counselor | 8829 Centre Street, Southaven, MS 38671 | 2009-04-21 |
| 1902089857 | Behavior, Attention, and Developmental Disabilities Consultants, LLC | Counselor | 5779 Getwell Rd Bldg D3, Southaven, MS 38672-6351 | 2007-12-14 |
| 1184827685 | Amy H Gallimore | Counselor | 1630 Custer Dr, Southaven, MS 38671-5229 | 2007-06-11 |
| 1982795290 | Jessica Irene Stockman | Counselor | 7075 Golden Oaks Loop W, Ste. 3, Southaven, MS 38671-9010 | 2006-09-28 |
| 1598865339 | Mae C Young | Counselor | 230 Goodman Rd E, Suite 102 Building 3, Southaven, MS 38671-5154 | 2006-09-22 |
| 1700830122 | Melissa M Sisco | Counselor | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671-9493 | 2006-05-20 |
| Find all providers in SOUTHAVEN | ||||
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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.