Naomi Fortune Muffuletto

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2055 Issued in MS

Practice address

1151 North State Street
Suite 212
Jackson, MS 39202-2467

Phone

(601) 352-7398

NPI assigned

Aug 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Live Oak Psychological Associtaes

  • Clinical Psychologist
  • Jackson, MS
  • NPI 1750577805
  NPD (past)

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1043734080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 TIMBERLAND TER",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107196",
            "telephone_number": "601-906-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 NORTH STATE STREET",
            "address_2": "SUITE 212",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022467",
            "telephone_number": "601-352-7398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 Fontaine Place",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "39157",
            "country_code": "US",
            "telephone_number": "601-991-3080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUFFULETTO",
        "first_name": "NAOMI",
        "middle_name": "FORTUNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MS",
            "license": "2055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ms State Department of Health Pharmacy
• Ms State Dept of Health
• Ms State Dept of Health
• Ms State Dept of Health Pharmacy
• Ms Wound Care
• Aun Muhammad, M.B.B.S.
• David Henry Mulholland, MD
• John Andrew Mulkey
• Richard M Mullaney, M.D.
• Alexander Joseph Mullen, MD

• Marriage & Family Therapist in Jackson, MS
• Providers in Jackson, MS by specialty
• Marriage & Family Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.