Delta Community Mental Health Services
Organization Active NPI Community/Behavioral Health Agency · Cleveland, MS
NPI 1184741100 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1184741100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 16335 (MS)
- Legal business name
- DELTA COMMUNITY MENTAL HEALTH SERVICES
- Practice address
- 113A S Davis Ave
Cleveland, MS 38732-3447 - Phone
- (662) 843-9445
- Fax
- (662) 843-9447
- NPI assigned
- Mar 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Gilbert Macvaugh, PSY
- Title
- Executive Director
- Phone
- (662) 335-5274
Corporate family (same tax ID) 3
Practitioners 8
-
Jessica Colin Humbarger, LMSW, PCMHT
-
Keandrea Jackson, M.A.
-
Phyllis McCreary, R.N.
-
Mary Elizabeth Prestage, M.A.
-
Jacqueline Todd, M.A.
-
Surkinnia Woods, M.A.
-
Dolores Gordon-Williams, M.S.
National Provider Directory
- Tax ID family
- Delta Community Mental Health Services
Locations
113A S Davis Ave
Cleveland, MS 38732
Phone (662) 843-9445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 16335 | MS | Yes |
Addresses
Primary practice location
113A S Davis Ave
Cleveland, MS 38732-3447
Mailing address
113A S Davis Ave
Cleveland, MS 38732-3447
Phone (662) 843-9445
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018205 | Medicaid | MS |
Other providers in Cleveland, MS
- Davis Unlimited Healthcare Services, PLLC
- Christen Davis
- Kimberly Leatrice Davis
- Elizabeth Paden-Walker Dawkins
- Ashlyn Myers De Regt
- Delta Corner Properties, LLC
- Delta Counseling Services LLC
- Delta Family Dental, PLLC
- Delta Health Center, Inc
- Delta Health System
All providers in Cleveland, MS · Community/Behavioral Health Agency in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.