Saja B Mboge

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

Q3-0010588 Issued in DE

Practice address

340 Stateline Rd W
Southaven, MS 38671-1610

Phone

(662) 510-5387

Fax

(662) 342-0782

NPI assigned

May 11, 2021

Sex

Male

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

Enrolled in DE, TN2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bloom Haven Mental Health L.L.C

  • Clinical Social Worker
  • Cordova, TN
  • NPI 1245170687
  NPD Authorized official
• Uplift Behavioral Health PC

  • Adult Mental Health Clinic/Center
  • Bethesda, MD
  • NPI 1629740410

  DE, TN

  Medicare reassignment
• Addiction Campuses Professional Services of Mississippi, LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Southaven, MS
  • NPI 1659990075
  NPD
• Addiction Campuses of Mississippi, LLC

  • Substance Abuse Rehabilitation Facility
  • Southaven, MS
  • NPI 1356703524
  NPD (past)

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1063096469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9216 SPEERBERRY LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160900",
            "telephone_number": "901-425-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711610",
            "telephone_number": "662-510-5387",
            "fax_number": "662-342-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOGE",
        "first_name": "SAJA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q3-0010588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew W Crain
• Terry Matthews
• George A May Jr., DDS
• Mays Medical Wellness, LLC
• Tracey L Mays, F.N.P.
• Jane Elizabeth McAdory, MD
• Alicia Caroline McAuley, PLPC
• Christina Marie McCafferty
• Antonio McCall
• Michael Patrick McCallum, MS, PCMHT

• Clinical Social Worker in Southaven, MS
• Providers in Southaven, 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 May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.