MCWILLIE COUNSELING & DIAGNOSTIC SERVICES (NPI# 1780852194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780852194 |
| Entity Type | Organization |
| Organization Name | MCWILLIE COUNSELING & DIAGNOSTIC SERVICES |
| Practice Address |
5202 Keele St Ste 1 Jackson MS 39206-4355 |
| Mailing Address |
5202 Keele Street, Suite 1 Jackson MS 39206 |
| Practice Telephone | 6019828624 |
| Mailing Telephone | 6019828624 |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |
| Authorized Official Name | DR. DELILAH J. MOORE (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 6019828624 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
00281 | MS | Ambulatory Health Care Facilities |
| Street Address |
5202 KEELE ST STE 1 |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-4355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103127 | Lupine Mental Health and Integrative Psychiatry LLC | Clinic/Center | 125 E Pearl Ave Ste 207, Jackson, WY 83001-8599 | 2020-08-02 |
| 1750908182 | Horizon Connections | Clinic/Center | 1818 Crane Ridge Dr Ste 101, Jackson, MS 39216-4912 | 2020-07-01 |
| 1295211787 | Nicole Rue, Psy.d., LLC | Clinic/Center | 1115 Maple Way Ste D, Jackson, WY 83001-8567 | 2018-07-17 |
| 1881102408 | Ava Family Services, LLC | Clinic/Center | 1910 Lakeland Dr Ste C, Jackson, MS 39216 | 2018-01-17 |
| 1033628466 | Bhg Lii, LLC | Clinic/Center | 794 Mcdonough Rd Ste 104, Jackson, GA 30233-1572 | 2017-09-28 |
| 1356732317 | Golden Gold Child Learning Center | Clinic/Center | 1155 Jackson Blvd, Jackson, MS 39204-2733 | 2015-02-12 |
| 1194964049 | Beacon Behavioral Health-jackson | Clinic/Center | 5360 I 55 N, Jackson, MS 39211-4026 | 2009-02-17 |
| 1134366867 | Mississippi State Hospital | Clinic/Center | 350 Capers Ave, Jackson, MS 39203-2131 | 2009-01-16 |
| 1689628190 | Catholic Charities of Jackson, Lenawee and Hillsdale Counties | Clinic/Center | 1522 Joy Ave, Jackson, MI 49203-1933 | 2006-05-20 |
| 1063466274 | Jackson-hillsdale Community Mental Health Board | Clinic/Center | 1200 N. West Avenue, Jackson, MI 49202 | 2006-05-20 |
| 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.