Sallie Evans Dalton, MSN, APRN, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Philadelphia, MS
NPI 1104472653 · NPPES record last updated Nov 28, 2023
Key facts
- NPI
- 1104472653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 903430 (MS)
- Practice address
- 1012 E Main St
Philadelphia, MS 39350-2308 - Phone
- (601) 389-7889
- Fax
- (601) 533-2566
- NPI assigned
- Aug 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- A Good Mind Too
Practice addresses (Care Compare)
1012 E Main St
Philadelphia, MS 39350-2308
Phone (601) 416-0068
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201001002863 | MS | Practitioner - Nurse Practitioner | 4688093149 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 903430 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intouch Psychological Services LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| A Good Mind Too | Psychiatric/Mental Health | Current |
Accepting new patients |
| Precise Clinical Neuroscience Specialists | Past |
Accepting new patients |
Locations
2502 9th St
Meridian, MS 39301
Phone (601) 512-0927
1012 E Main St
Philadelphia, MS 39350
Phone (601) 389-7889
1012 E Main St
Ste 24
Philadelphia, MS 39350
1120 E Main St
Ste 24
Philadelphia, MS 39350
Phone (601) 781-8677
Interoperability endpoints
- agoodmindtoo.salliedalton@153743.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 903430 | MS | Yes |
Addresses
Primary practice location
1012 E Main St
Philadelphia, MS 39350-2308
Mailing address
1012 E Main St Ste 24
Philadelphia, MS 39350-2308
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841933272 | Other | NPI 2 | |
| 09876307 | Medicaid | MS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | SALLIEDALTON@AGOODMINDTOO.COM | Direct |
Other providers in Philadelphia, MS
- Covenant Palliative and Hospice, LLC
- Cumberland Chiropractic Clinic
- Sarah Kathryn Cummings
- Kiara Cunningham
- Andrew Pace Dabbs
- Shelley Darby
- Zaineb Daud
- Adrian Dennis
- Morgan Elizabeth Deweese
- Ricky Gene Deweese
All providers in Philadelphia, MS · Psychiatric/Mental Health Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.