LIVE OAK PSYCHOLOGICAL ASSOCITAES (NPI# 1750577805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750577805 |
| Entity Type | Organization |
| Organization Name | LIVE OAK PSYCHOLOGICAL ASSOCITAES |
| Practice Address |
1151 N State St Ste 212 Jackson MS 39202-2407 |
| Practice Telephone | 6013527398 |
| Practice Fax Number | 6013520442 |
| Mailing Telephone | 6013527398 |
| Mailing Fax Number | 6013520442 |
| Enumeration Date | 2007-09-22 |
| Last Update Date | 2007-09-22 |
| Authorized Official Name | MRS. LISA HALDERMAN DIETH (OFFICE MANAGER) |
| Authorized Official Telephone | 6013527398 |
| 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 |
1151 N STATE ST STE 212 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003953 | Barry Whites | Internal Medicine | 1151 N State St, Ste 617, Jackson, MS 39202-2407 | 2005-06-16 |
| 1275182537 | Qianwen Williamson | Registered Nurse | 1151 N State St, Jackson, MS 39202-2407 | 2019-09-10 |
| 1982057592 | Deborah Fortenberry | Hearing Instrument Specialist | 1151 N State St, Suite 107, Jackson, MS 39202-2407 | 2016-07-19 |
| 1053729285 | Michael Garret Shumaker | Counselor | 1151 N State St, Jackson, MS 39202-2407 | 2014-07-31 |
| 1962823344 | Jackson Pain Center Pa | Anesthesiology | 1151 N State St, Suite 311, Jackson, MS 39202-2407 | 2014-01-02 |
| 1609137868 | Ellen C Lee | Nurse Practitioner | 1151 N State St, Suite 511, Jackson, MS 39202-2407 | 2012-06-05 |
| 1902032089 | Eric Welsh | Marriage & Family Therapist | 1151 N State St, Suite 212, Jackson, MS 39202-2407 | 2009-06-03 |
| 1659539351 | Medical Arts Dental Group P.a. | Dentist | 1151 N State St, Suite 401, Jackson, MS 39202-2407 | 2008-05-29 |
| 1154543627 | Sarah R. Guy | Anesthesiology | 1151 N State St, Suite 311, Jackson, MS 39202 | 2007-05-03 |
| 1780804351 | Spine Medical Center of Jackson | Physical Medicine & Rehabilitation | 1151 N State St, Suite 508, Jackson, MS 39202-2407 | 2007-04-26 |
| Find all providers in the same location | ||||
| 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 | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043756174 | Maribeth L. Hesser | Psychologist | 6675 N Upper Cascade Dr, Jackson, WY 83001-9390 | 2017-01-12 |
| 1215375746 | Payne Behavioral Medicine | Psychologist | 4005 N State St Ste N, Jackson, MS 39206-5755 | 2013-06-06 |
| 1598002610 | Kimberly D Weaver | Psychologist | 207 First Street, Jackson, MI 49201 | 2013-01-09 |
| 1497027775 | Fitness Clinic | Psychologist | 2219 Greenway Dr, Jackson, MS 39204-3202 | 2012-02-02 |
| 1760752976 | Mitchell S. Weisbrod, Psy.d., Pllc | Psychologist | 115 S West Ave Ste 1, Jackson, MI 49201-2085 | 2012-01-04 |
| 1275830887 | Martin E Cleveland Phd Pllc | Psychologist | 5 Brentmeade Cv, Jackson, TN 38305-6448 | 2011-02-16 |
| 1154636611 | Shannon Monique Moore | Psychologist | 1675 Lakeland Dr Ste 304, Jackson, MS 39216 | 2010-08-09 |
| 1598076903 | Nanetta S Payne | Psychologist | 4005 N State St, Suite N, Jackson, MS 39206-5755 | 2010-06-30 |
| 1932422763 | Marion Counseling Services, Pllc | Psychologist | 2095 Dunbarton Dr, Suite 103, Jackson, MS 39216-5017 | 2010-03-08 |
| 1457548737 | Deborah Ruddy Hansen | Psychologist | 6 Universal Way, Jackson, MI 49202-1455 | 2007-10-01 |
| 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.