NPIMap

Organization Active NPI

Jackson Comprehension Treatment Center

  • Addiction (Substance Use Disorder) Counselor
  • Jackson, MS
National Provider Identifier
1003757675
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
JACKSON COMPREHENSION TREATMENT CENTER
Practice address
1935 Lakeland Dr Ste 900
Jackson, MS 39216-5028
Phone
(601) 718-2468
NPI assigned
Apr 6, 2026
Last updated
Apr 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Mr. Derrick Dewayner Davis, MSWNPI 1972447621
Title
3C
Phone
(601) 718-2468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

1935 Lakeland Dr Ste 900
Jackson, MS 39216-5028

Mailing address

3333 W Northside Dr Lot 17
Clinton, MS 39056-3353
Phone (601) 926-0569

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1003757675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 W NORTHSIDE DR LOT 17",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563353",
            "telephone_number": "601-926-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 LAKELAND DR STE 900",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165028",
            "telephone_number": "601-718-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COMPREHENSION TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "DEWAYNER",
        "authorized_official_title_or_position": "3C",
        "authorized_official_telephone_number": "601-718-2468",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.