Ju'Daijah Banks
Individual provider Active NPI Counselor · Brookhaven, MS
NPI 1265040992 · NPPES record last updated Jul 20, 2020
Key facts
- NPI
- 1265040992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1377 Johnny Johnson Dr
Brookhaven, MS 39601-9641 - Phone
- (601) 990-2398
- Fax
- (601) 990-2232
- NPI assigned
- Jul 20, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi Behavioral Health Services, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1377 Johnny Johnson Dr
Brookhaven, MS 39601-9641
Mailing address
860 E River PL Ste 100
Jackson, MS 39202-3442
Phone (769) 251-5550
Other providers in Brookhaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 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.