Active NPI
Jasmine Kinchen, IDD SERVICES
- Counselor
- Laurel, MS
National Provider Identifier
1154048015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 934 West Dr
Laurel, MS 39440-4702 - Phone
- (601) 426-7520
- NPI assigned
- Oct 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
934 West Dr
Laurel, MS 39440-4702
Mailing address
PO Box 18679
Hattiesburg, MS 39404-8679
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Region 12 Commission on Mental Health & Retardation Pine Belt Men | Past | Accepting new patients | |
| Region XII Commission | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hattiesburg, MS
- NPI 1982610572
-
- General Practice Physician
- Laurel, MS
- NPI 1467767988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1154048015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18679",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394048679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "934 WEST DR",
"city": "LAUREL",
"state": "MS",
"postal_code": "394404702",
"telephone_number": "601-426-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINCHEN",
"first_name": "JASMINE",
"credential": "IDD SERVICES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-21",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.