Active NPI
Carlissa Washington
- Social Worker
- Holly Springs, MS
National Provider Identifier
1316400294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 175 Whaley Dr Ste B&C
Holly Springs, MS 38635-3253 - Phone
- (662) 247-3220
- NPI assigned
- Apr 9, 2019
- Last updated
- Apr 9, 2019
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
175 Whaley Dr Ste B&C
Holly Springs, MS 38635-3253
Mailing address
2525 Youree Dr Ste 110
Shreveport, LA 71104-3600
Phone (318) 742-3408
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554768000000",
"number": "1316400294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 YOUREE DR STE 110",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711043600",
"telephone_number": "318-742-3408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 WHALEY DR STE B&C",
"city": "HOLLY SPRINGS",
"state": "MS",
"postal_code": "386353253",
"telephone_number": "662-247-3220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHINGTON",
"first_name": "CARLISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-09",
"last_updated": "2019-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Springs, MS
- Tyson Drugs Inc (Tysons Medical Center Pharmacy)
- Tyson Drugs Inc
- Unity Home Medical, LLC
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0303)
- Hanson Walker, PHARMD
- West Clinic PC (Memphis Heart Clinic)
- Dorothy Seale Whisenant, RPH
- Tenobia Leshay White, CNA, CMA
- Bridget Wicks, LMSW, LADAC, LIAC,
- Myra Wilkins
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.