MATTISON LANIER ELLIS (NPI# 1851461917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851461917 |
| Entity Type | Individual |
| Full Name | MATTISON LANIER ELLIS |
| Credential | LPC |
| Practice Address |
8829 Centre St Suite 105 Southaven MS 38671-2610 |
| Practice Telephone | 6622806777 |
| Practice Fax Number | 6622806775 |
| Mailing Telephone | 6622806777 |
| Mailing Fax Number | 6622806775 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
1112 | MS | Behavioral Health & Social Service Providers |
| Street Address |
8829 CENTRE ST SUITE 105 |
| 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 |
| 1568837870 | Kattrina Roach | Counselor | 8829 Centre St, Southaven, MS 38671-2610 | 2015-12-11 |
| 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 |
| 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.