Active NPI
Chevonna Milloy-Bass
- Counselor
- Hattiesburg, MS
National Provider Identifier
1285807875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 1051
- Practice address
- 103 S 19TH Ave
Hattiesburg, MS 39401-6171 - Phone
- (601) 544-4641
- Fax
- (601) 584-4053
- NPI assigned
- Apr 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1051 | MS | Primary |
Addresses
Primary practice location
103 S 19TH Ave
Hattiesburg, MS 39401-6171
Mailing address
103 S 19TH Ave
Hattiesburg, MS 39401-6171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Associates of New London PLLC | Current | Accepting new patients |
Locations
525 N Main St
Hattiesburg, MS 39401
Phone 6016994080 ext. 125
35 Newport Rd
New London, NH 03257
Phone (603) 526-4230
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207267200000",
"number": "1285807875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 S 19TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394016171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 S 19TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394016171",
"telephone_number": "601-544-4641",
"fax_number": "601-584-4053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLOY-BASS",
"first_name": "CHEVONNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-04",
"last_updated": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MS",
"license": "1051",
"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 Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.