Individual provider Active NPI

Michael David Prazak Jr., PHD, LP

  • Counseling Psychologist
  • Biloxi, MS
National Provider Identifier
1144838251
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2158 Issued in AL
Practice address
400 Veterans Ave
Biloxi, MS 39531-2410
Phone
(228) 523-5000
NPI assigned
Jul 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 2158 AL Primary

Addresses

Primary practice location

400 Veterans Ave
Biloxi, MS 39531-2410

Mailing address

400 Veterans Ave
Biloxi, MS 39531-2410
Phone (228) 523-5000

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
I20240805000697 MS Practitioner - Clinical Psychologist 4688111081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Psychological Associates, PLLCGroup PAC ID 5698212413, 2 clinicians

Practice addresses (Care Compare)

Ocean Springs, MS 39564
Phone (812) 760-5347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2158ALMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Psychological Associates, PLLC CurrentSince Jun 19, 2024 Accepting new patients

Locations

2953 Bienville Blvd
Ocean Springs, MS 39564

21 Marks Rd
Ocean Springs, MS 39564
Phone (228) 215-6800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1144838251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 VETERANS AVE",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312410",
            "telephone_number": "228-523-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VETERANS AVE",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312410",
            "telephone_number": "228-523-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAZAK",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AL",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.