Active NPI
Angela Tamekia Harvey, LCMHT
- Mental Health Counselor
- Jackson, MS
National Provider Identifier
1316237704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1005
- Practice address
- 3450 Highway 80 W
Jackson, MS 39209-7201 - Phone
- (601) 321-2497
- Fax
- (601) 321-2476
- NPI assigned
- Apr 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1005 | MS | Primary |
Addresses
Primary practice location
3450 Highway 80 W
Jackson, MS 39209-7201
Mailing address
3450 Highway 80 W
Jackson, MS 39209-7201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018209 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1005 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1316237704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 HIGHWAY 80 W",
"city": "JACKSON",
"state": "MS",
"postal_code": "392097201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 HIGHWAY 80 W",
"city": "JACKSON",
"state": "MS",
"postal_code": "392097201",
"telephone_number": "601-321-2497",
"fax_number": "601-321-2476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARVEY",
"first_name": "ANGELA",
"middle_name": "TAMEKIA",
"credential": "LCMHT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "1005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00018209",
"state": "MS"
}
],
"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 Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.