CYNTHIA LUFKIN UNDESSER (NPI# 1841337656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1841337656 |
Entity Type | Individual |
Full Name | CYNTHIA LUFKIN UNDESSER |
Credential | M.D. |
Practice Address |
402 Wesley Ave Jackson MS 39202-1000 |
Practice Telephone | 6013600583 |
Practice Fax Number | 6013600585 |
Mailing Telephone | 6013600583 |
Mailing Fax Number | 6013600585 |
Enumeration Date | 2007-01-31 |
Last Update Date | 2007-07-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
11891 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | MEDICAL LICENSURE | G5719 | 01 |
MS | 00117736 | 05 |
Street Address |
402 WESLEY AVE |
City | JACKSON |
State | MS |
Zip Code | 39202-1000 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639382690 | Cares Center Inc | Psychiatric Residential Treatment Facility | 402 Wesley Ave, Jackson, MS 39202 | 2007-05-07 |
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 | 2084P0804X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Child & Adolescent Psychiatry |
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144512674 | Magalie Saint-lot Jacques | Psychiatry & Neurology | 31 Bridgewater Ct, Jackson, NJ 08527-4030 | 2011-05-03 |
1992047682 | Nils Charles Westfall | Psychiatry & Neurology | 555 E Broadway Ave Ste 204, Jackson, WY 83001-8640 | 2013-03-21 |
1922372697 | Integrated Family Services, Pllc | Psychiatry & Neurology | 9486 Nc Hwy 305, Jackson, NC 27845-9679 | 2012-02-28 |
1548357643 | Scott Rodgers | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216-4500 | 2006-10-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649466954 | Nazmul Talukdar | Psychiatry & Neurology | 110 Patton Ave, Hattiesburg, MS 39401-6155 | 2007-09-20 |
1932321742 | Otis Anderson IIi | Psychiatry & Neurology | 5185 Getwell Rd, Southaven, MS 38671-9691 | 2007-05-02 |
1770609364 | Gerri L Hill Chance | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazelhurst, MS 39083 | 2007-03-22 |
1932290392 | Millcreek Epsdt | Psychiatry & Neurology | 900 First Ave., N.e., Magee, MS 39111 | 2006-09-28 |
1639620560 | North Plantation | Psychiatry & Neurology | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-15 |
1023363173 | Kelechi Nnamdi Emereonye | Psychiatry & Neurology | 4100 Mamie St, Hattiesburg, MS 39402-1735 | 2012-07-16 |
1710175260 | Clinical Neuroscience Group, Pllc | Psychiatry & Neurology | 3531 Lakeland Dr, Suite 1058, Flowood, MS 39232-8049 | 2007-10-10 |
1992906598 | Maecenas Inc | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazlehurst, MS 39083-0146 | 2007-05-30 |
1154477453 | Anthony Wade Jackson Sr. | Psychiatry & Neurology | 152 Highway 7 S, Oxford, MS 38655-5392 | 2007-01-27 |
1073684940 | Timothy Summers | Psychiatry & Neurology | 1818 College Drive, Meridian, MS 39307-5429 | 2006-11-13 |
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.