NPIMap

Organization Active NPI

Psycamore, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flowood, MS
National Provider Identifier
1285722678
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PSYCAMORE, LLC
Practice address
2540 Flowood Dr
Flowood, MS 39232-9362
Phone
(601) 939-5993
Fax
(601) 939-5935
NPI assigned
Oct 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kimberly Madakasira, LPC
Title
Vice President
Phone
(601) 939-5993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

2540 Flowood Dr
Flowood, MS 39232-9362

Mailing address

2540 Flowood Dr
Flowood, MS 39232-9362
Phone (601) 939-5993

National Provider Directory

National Provider Directory
Tax ID family
Psycamore LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285722678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329362",
            "telephone_number": "601-939-5993",
            "fax_number": "601-939-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329362",
            "telephone_number": "601-939-5993",
            "fax_number": "601-939-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCAMORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MADAKASIRA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "601-939-5993",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.