Individual provider Active NPI

Marilyn S Snow, PH.D. ,LPC

  • Professional Counselor
  • Southaven, MS
National Provider Identifier
1003917535
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
675 Issued in MS
Practice address
8626 Airways Blvd
Southaven, MS 38671-2603
Phone
(662) 772-5937
Fax
(662) 772-5940
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC002368 GA
Professional Counselor 101YP2500X 675 MS Primary

Addresses

Primary practice location

8626 Airways Blvd
Southaven, MS 38671-2603

Mailing address

PO Box 1980
Southaven, MS 38671-0023
Phone (662) 772-5937

Other practice location 1

256 W Washington St
Madison, GA 30650
Phone (706) 438-3003

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address officemgr@desotofamilycounseling.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260311001764 MS Practitioner - Mental Health Counselor 1052894755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desoto Family Counseling Center PLLCGroup PAC ID 1254511686, 11 clinicians

Practice addresses (Care Compare)

8626 Airways Blvd
Southaven, MS 38671-2603
Phone (662) 772-5937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC002368GAMDProfessional Counselor
675MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto Family Counseling Center PLLC Professional CurrentSince Jan 1, 2026 Accepting new patients
M S Publishing and Consulting LLC Professional Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1003917535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1980",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386710023",
            "telephone_number": "662-772-5937",
            "fax_number": "662-772-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8626 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712603",
            "telephone_number": "662-772-5937",
            "fax_number": "662-772-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "256 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "GA",
            "postal_code": "30650",
            "country_code": "US",
            "telephone_number": "706-438-3003",
            "fax_number": "762-220-1801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW",
        "first_name": "MARILYN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D. ,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC002368",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "officemgr@desotofamilycounseling.org",
            "affiliation": "N",
            "endpointDescription": "Credentialing Conta ct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Main Location",
            "address_1": "8626 Airways Blvd",
            "city": "Southaven",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386712603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.