Individual provider Active NPI

Jacob Alden Dennee

  • Marriage & Family Therapist
  • Hattiesburg, MS
National Provider Identifier
1154123263
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
TA11463 Issued in MS
Practice address
15 Millbranch Rd
Hattiesburg, MS 39402-1413
Phone
(601) 818-0471
NPI assigned
Mar 27, 2025
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X TA11463 MS Primary

Addresses

Primary practice location

15 Millbranch Rd
Hattiesburg, MS 39402-1413

Mailing address

15 Millbranch Rd
Hattiesburg, MS 39402-1413
Phone (601) 818-0471

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

State licenses

LicenseStateTypeSpecialty
TA11463MSMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1154123263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MILLBRANCH RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021413",
            "telephone_number": "601-818-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MILLBRANCH RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021413",
            "telephone_number": "601-818-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNEE",
        "first_name": "JACOB",
        "middle_name": "ALDEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MS",
            "license": "TA11463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.