Active NPI
Bessie R. Fortenberry, LPC, LSW
- Counselor
- Brandon, MS
National Provider Identifier
1043723794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 0091
- Practice address
- 1733 Highway 471
Brandon, MS 39047-8301 - Phone
- (601) 825-3370
- NPI assigned
- Nov 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | W0242 | MS | |
| Counselor | 101Y00000X | 0091 | MS | Primary |
Addresses
Primary practice location
1733 Highway 471
Brandon, MS 39047-8301
Mailing address
1733 Highway 471
Brandon, MS 39047-8301
Phone (601) 825-3370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0091 | MS | MD | Counselor |
| W0242 | MS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510704000000",
"number": "1043723794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1733 HIGHWAY 471",
"city": "BRANDON",
"state": "MS",
"postal_code": "390478301",
"telephone_number": "601-825-3370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1733 HIGHWAY 471",
"city": "BRANDON",
"state": "MS",
"postal_code": "390478301",
"telephone_number": "601-825-3370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTENBERRY",
"first_name": "BESSIE",
"middle_name": "R.",
"credential": "LPC, LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-15",
"last_updated": "2017-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MS",
"license": "W0242",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MS",
"license": "0091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.