Jessica Denise Tatum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C10503 Issued in MS

Practice address

665 S Pear Orchard Rd
Ridgeland, MS 39157-4861

Phone

(601) 345-1906

NPI assigned

Mar 3, 2023

Sex

Female

Sole proprietor

No

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.

• Mindful Thoughts LLC

  • Clinical Social Worker
  • Ridgeland, MS
  • NPI 1831974260
  NPD Authorized official

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1043910565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 884",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391110884",
            "telephone_number": "601-316-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 S PEAR ORCHARD RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574861",
            "telephone_number": "601-345-1906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Narrow Rd",
            "address_purpose": "LOCATION",
            "city": "Mendenhall",
            "state": "MS",
            "postal_code": "391145432",
            "country_code": "US",
            "telephone_number": "601-316-8046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "604 Highway 80 W",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "390564108",
            "country_code": "US",
            "telephone_number": "601-473-2106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "JESSICA",
        "middle_name": "DENISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C10503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnson Dean Tanner, M.D.
• Laura Katherine Taranto
• Tonja M Tarvin, LCSW
• Anna Katherine Tate, BCBA
• Allison Tatum
• Latoya Kiera Taylor-Cooper, NP
• Anna Taylor
• Jacqueline S Taylor, LPC
• Katherine Elizabeth Taylor, APRN, FNP-BC
• Tonia Taylor, PHD

• Clinical Social Worker in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.