Anchored Hope Clinic, PLLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Hattiesburg, MS

NPI 1093485930 · NPPES record last updated Jan 15, 2022

Key facts

NPI
1093485930
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
ANCHORED HOPE CLINIC, PLLC
Practice address
423 Weathersby Rd Ste 180
Hattiesburg, MS 39402-1132
Phone
(601) 376-9144
Fax
(601) 429-9300
NPI assigned
Sep 13, 2021
Organization subpart
No

Authorized official

Name
Racheal Pritchett, PMHNP
Title
Member
Phone
(601) 376-9144

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20211007000015 MS Part B Supplier - Clinic/Group Practice 8123426012 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MS

National Provider Directory

Locations

220 W Pine St
Hattiesburg, MS 39401
Phone (601) 337-9995

2626 Southerland St
Ste 100
Jackson, MS 39216
Phone (601) 376-9144

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

423 Weathersby Rd Ste 180
Hattiesburg, MS 39402-1132

Mailing address

423 Weathersby Rd Ste 180
Hattiesburg, MS 39402-1132
Phone (601) 376-9144

Other practice location 1

2626 Southerland St Ste 100
Jackson, MS 39216-4825
Phone (601) 376-9144

Other names

  • Anchored Hope Clinic Doing business as

Other providers in Hattiesburg, MS

All providers in Hattiesburg, MS · Psychiatric/Mental Health Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.