Individual provider Active NPI

Sylvia Sessions Stogner, LCSW

  • Clinical Social Worker
  • Tylertown, MS
National Provider Identifier
1164436838
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C2589 Issued in MS
Practice address
729 Beulah Ave
Tylertown, MS 39667-2709
Phone
(601) 876-2611
Fax
(601) 876-4379
NPI assigned
Jul 28, 2006
Last updated
Feb 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C2589 MS Primary

Addresses

Primary practice location

729 Beulah Ave
Tylertown, MS 39667-2709

Mailing address

48 Old Settlement Rd
Tylertown, MS 39667-4977
Phone (601) 876-2611

Other identifiers 1

IdentifierTypeStateIssuer
06687044MedicaidMS

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
I20100209000533 MS Practitioner - Clinical Social Worker 3678616976 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C2589MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Walthall County Behavioral Services CurrentSince Oct 16, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients

Locations

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

125 Old State Line Rd
Tylertown, MS 39667
Phone (601) 303-0472

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1164436838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 OLD SETTLEMENT RD",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396674977",
            "telephone_number": "601-876-2611",
            "fax_number": "601-876-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 BEULAH AVE",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396672709",
            "telephone_number": "601-876-2611",
            "fax_number": "601-876-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOGNER",
        "first_name": "SYLVIA",
        "middle_name": "SESSIONS",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C2589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06687044",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tylertown, MS

Sources for this page

Verify at the official NPI Registry.