Active NPI
Magnolia Crossing Mental Health Services LLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jackson, MS
National Provider Identifier
1285324640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- MAGNOLIA CROSSING MENTAL HEALTH SERVICES LLC
- Practice address
- 4780 I 55 N Ste 100
Jackson, MS 39211-5583 - Phone
- (318) 490-8825
- NPI assigned
- May 10, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tritresher Sizer, PMHNP
- Title
- Psychiatric Nurse Practitioner
- Phone
- (601) 937-3526
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
4780 I 55 N Ste 100
Jackson, MS 39211-5583
Mailing address
323 Kings Ridge Cir
Brandon, MS 39047-6031
National Provider Directory
National Provider DirectoryLocations
407 Briarwood Dr
Ste 210E
Jackson, MS 39206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683676800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1700438400000",
"number": "1285324640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 KINGS RIDGE CIR",
"city": "BRANDON",
"state": "MS",
"postal_code": "390476031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4780 I 55 N STE 100",
"city": "JACKSON",
"state": "MS",
"postal_code": "392115583",
"telephone_number": "318-490-8825"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAGNOLIA CROSSING MENTAL HEALTH SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-10",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A",
"authorized_official_last_name": "SIZER",
"authorized_official_first_name": "TRITRESHER",
"authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
"authorized_official_telephone_number": "601-937-3526",
"authorized_official_credential": "PMHNP"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.