Fulivia Elma Cannady, MSCP,NCC,LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

208894 Issued in MS

Practice address

113B Willow Brook Dr
Clinton, MS 39056-5802

Phone

(601) 832-8264

NPI assigned

Feb 17, 2009

Last updated

Feb 17, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Fulivia Elma Banks Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Impact Behavioral Counseling LLCGroup PAC ID 1355604836, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Impact Behavioral Counseling LLC

  • Addiction (Substance Use Disorder) Counselor
  • Jackson, TN
  • NPI 1386169050

  MS

  Medicare reassignment Care Compare group NPD
• Pathway Healthcare- Mississippi LLC

  • Addiction Medicine (Family Medicine) Physician
  • Laurel, MS
  • NPI 1013425503
  NPD (past)

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1306085253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113B WILLOW BROOK DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565802",
            "telephone_number": "601-832-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113B WILLOW BROOK DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565802",
            "telephone_number": "601-832-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNADY",
        "first_name": "FULIVIA",
        "middle_name": "ELMA",
        "name_prefix": "Mrs.",
        "credential": "MSCP,NCC,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "208894",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FULIVIA",
            "last_name": "BANKS",
            "middle_name": "ELMA",
            "prefix": "MISS",
            "credential": "MSCP,NCC,LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chadwick Cabanero, PHARMD
• Cac Therapy Group, LLC
• Catherine E. Callender, L.C.S.W.
• Tara Cameron, PHARMD
• William Michael Campbell, DMD
• Capitaleyes, Inc (Southern Eyecare of Clinton)
• Care Center of Clinton
• Careplus Lakeview Family Medicine
• Carol Homecare Agency, LLC (Senior Helpers of Central Mississippi)
• Amanda Monique Carson-Griffin, FNP-BC

• Counselor in Clinton, MS
• Providers in Clinton, MS by specialty
• Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.