NPIMap

Organization Active NPI

Psychology Associates, LLC

  • Psychologist
  • Meridian, MS
National Provider Identifier
1336335546
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PSYCHOLOGY ASSOCIATES, LLC
Practice address
5004 Hwy 39 N
Meridian, MS 39301-1021
Phone
(601) 693-8307
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Sandra Mackrell
Title
Office Manager
Phone
(601) 693-8307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

5004 Hwy 39 N
Meridian, MS 39301-1021

Mailing address

5004 Hwy 39 N
Meridian, MS 39301-1021
Phone (601) 693-8307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120118000562 MS Part B Supplier - Clinic/Group Practice 9739356684 Receives reassigned benefits from 11 practitioners
Practice locations: Meridian, MS

National Provider Directory

National Provider Directory

Locations

5004 Highway 39 N
Meridian, MS 39301
Phone (601) 480-3011

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1336335546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 HWY 39 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393011021",
            "telephone_number": "601-693-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 HWY 39 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393011021",
            "telephone_number": "601-693-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "MACKRELL",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-693-8307"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.