Yasmeen Patricia Eichelberger, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C5009 Issued in MS

Practice address

510 George St
Ste 201
Jackson, MS 39202-3027

Phone

(601) 248-7561

Fax

(855) 387-8203

NPI assigned

Mar 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1184251555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4226 SUMMERTON DR",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728738",
            "telephone_number": "601-248-7561",
            "fax_number": "855-387-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 GEORGE ST",
            "address_2": "STE 201",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023027",
            "telephone_number": "601-248-7561",
            "fax_number": "855-387-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHELBERGER",
        "first_name": "YASMEEN",
        "middle_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C5009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.mindmattersms.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4226 Summerton Dr",
            "city": "Byram",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392728738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roberta W Edwards, SPEECH PATHOLOGIST
• Steveland Edwards
• Susan V Edwards, B.PH; PHARM.D.
• Talmadge Edwards
• Tanya M Edwards, LCSW
• Ekaa Healthcare LLC
• Vindhya Kumari Ekanayake
• Neva Penton Eklund, D.M.D.
• El Roi Counseling Services, LLC
• Alec Micheal Elder, DO

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.