Individual provider Active NPI

Catrice Tillis, CMHT

  • Mental Health Counselor
  • Meridian, MS
National Provider Identifier
1083428965
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1415 College Dr
Meridian, MS 39307-5345
Phone
(601) 483-4821
NPI assigned
Feb 3, 2025
Last updated
Feb 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1415 College Dr
Meridian, MS 39307-5345

Mailing address

PO Box 2868
Meridian, MS 39302-2868

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
I20250320001044 MS Practitioner - Mental Health Counselor 7517489495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Region Ten State of MsGroup PAC ID 4284605353, 13 clinicians

Practice addresses (Care Compare)

1415 College Dr
Meridian, MS 39307-5345
Phone 6014834821125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Region Ten Commission State of Ms CurrentSince Mar 12, 2025 Accepting new patients

Locations

1415 College Dr
Meridian, MS 39307
Phone (601) 483-4821

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1083428965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2868",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393022868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 COLLEGE DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075345",
            "telephone_number": "601-483-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLIS",
        "first_name": "CATRICE",
        "credential": "CMHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.