Individual provider Active NPI

Thomas Pough, MS, LPC, CSAT

  • Professional Counselor
  • Hattiesburg, MS
National Provider Identifier
1194151290
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1365 Issued in MS
Practice address
806 W Pine St
Hattiesburg, MS 39401-4259
Phone
(601) 466-2375
Fax
(601) 736-0287
NPI assigned
Sep 20, 2013
Last updated
Sep 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1365 MS Primary

Addresses

Primary practice location

806 W Pine St
Hattiesburg, MS 39401-4259

Mailing address

39 Bethany LN
Kokomo, MS 39643-4996
Phone (601) 466-2375

Other names 1

  • Mr. Odis D Pough Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1365MSMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1194151290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BETHANY LN",
            "city": "KOKOMO",
            "state": "MS",
            "postal_code": "396434996",
            "telephone_number": "601-466-2375",
            "fax_number": "601-736-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394014259",
            "telephone_number": "601-466-2375",
            "fax_number": "601-736-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUGH",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MS, LPC, CSAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ODIS",
            "last_name": "POUGH",
            "middle_name": "D",
            "prefix": "MR.",
            "credential": "SAA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 20, 2013; 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.