Active NPI
Katryn Scully
- Mental Health Counselor
- Hattiesburg, MS
National Provider Identifier
1356061832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- M12056
- Practice address
- 723 Hardy St
Hattiesburg, MS 39401-3666 - Phone
- (601) 436-7296
- Fax
- (601) 620-0037
- NPI assigned
- Sep 2, 2022
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | M12056 | MS | Primary |
Addresses
Primary practice location
723 Hardy St
Hattiesburg, MS 39401-3666
Mailing address
2119 W 10TH St
Laurel, MS 39440-2535
Phone (601) 620-0035
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 |
|---|---|---|---|
| 3704 | MS | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781740800000",
"number": "1356061832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 W 10TH ST",
"city": "LAUREL",
"state": "MS",
"postal_code": "394402535",
"telephone_number": "601-620-0035",
"fax_number": "601-620-0037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "723 HARDY ST",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394013666",
"telephone_number": "601-436-7296",
"fax_number": "601-620-0037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCULLY",
"first_name": "KATRYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-02",
"last_updated": "2026-06-18",
"certification_date": "2026-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "M12056",
"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 Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.