Beacon Behavioral Health-Jackson

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BEACON BEHAVIORAL HEALTH-JACKSON

Practice address

5360 I 55 N
Jackson, MS 39211-4026

Phone

(601) 373-4507

NPI assigned

Feb 17, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Wendell

Title

Ceo

Phone

(225) 810-4040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234828800000",
    "number": "1194964049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9938 AIRLINE HIGHWAY",
            "address_2": "SUITE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70816",
            "telephone_number": "225-810-4040",
            "fax_number": "225-810-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 I 55 N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114026",
            "telephone_number": "601-373-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BEHAVIORAL HEALTH-JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-02-17",
        "status": "A",
        "authorized_official_last_name": "WENDELL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-810-4040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Sofia Bayles, MS, LPC, NCC
• Janara Denise Baylis, LPN
• BB Speech Therapy, LLC
• Be Jay Pe LTD
• Rachel Beacham
• Beacon Behavioral Outpatient Jackson LLC
• Dewona Flowers Beal
• Monifa Ri'Ana Beal, FNP-BC
• Latrice Beale
• Jon Michael Beall, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Jackson, MS
• Providers in Jackson, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.