NPIMap

Organization Active NPI

Psycamore, LLC

  • Adult Mental Health Clinic/Center
  • Biloxi, MS
National Provider Identifier
1003195967
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
DCS-PSYCAMORE-PHA-01 Issued in MS
Legal business name
PSYCAMORE, LLC
Practice address
2620 Executive PL
Biloxi, MS 39531-3717
Phone
(228) 385-7744
Fax
(601) 939-5935
NPI assigned
Aug 10, 2011
Last updated
Dec 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Katherine A Hall, CMM
Title
Director, Business Operations
Phone
(601) 939-5993

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X DCS-PSYCAMORE-PHA-01 MS Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X DCS-PSYCAMORE-PHA-01 MS

Addresses

Primary practice location

2620 Executive PL
Biloxi, MS 39531-3717

Mailing address

2620 Executive PL
Biloxi, MS 39531-3717
Phone (601) 939-5993

National Provider Directory

National Provider Directory
Tax ID family
Psycamore LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2620 Executive Pl
Biloxi, MS 39531
Phone (228) 385-7744

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1003195967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 EXECUTIVE PL",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313717",
            "telephone_number": "601-939-5993",
            "fax_number": "601-939-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EXECUTIVE PL",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313717",
            "telephone_number": "228-385-7744",
            "fax_number": "601-939-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCAMORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "601-939-5993",
        "authorized_official_credential": "CMM"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MS",
            "license": "DCS-PSYCAMORE-PHA-01",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MS",
            "license": "DCS-PSYCAMORE-PHA-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.