Organization Active NPI

Olive Branch Counseling Services LLC

  • Clinical Social Worker
  • Hattiesburg, MS
National Provider Identifier
1285557058
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
OLIVE BRANCH COUNSELING SERVICES LLC
Practice address
702 W Pine St
Hattiesburg, MS 39401-3836
Phone
(601) 909-4220
NPI assigned
Jul 30, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Authorized official

Name
Shelby Davis, LCSWNPI 1740960699
Title
Owner/Therapist
Phone
(601) 909-4220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

702 W Pine St
Hattiesburg, MS 39401-3836

Mailing address

702 W Pine St
Hattiesburg, MS 39401-3836
Phone (601) 909-4220

National Provider Directory

National Provider Directory

Locations

702 W Pine St
Hattiesburg, MS 39401
Phone (817) 380-8115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1785369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1285557058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013836",
            "telephone_number": "601-909-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013836",
            "telephone_number": "601-909-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-30",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "601-909-4220",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 30, 2026; 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.