Active NPI
Savannah Wilson, MS
- Behavior Analyst
- Southaven, MS
National Provider Identifier
1356114805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 7075 Golden Oaks Loop W
Southaven, MS 38671-9010 - Phone
- (662) 228-0130
- NPI assigned
- Nov 6, 2023
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
7075 Golden Oaks Loop W
Southaven, MS 38671-9010
Mailing address
7075 Golden Oaks Loop W
Southaven, MS 38671-9010
Phone (662) 228-0130
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Irby Psychological Services, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1356114805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7075 GOLDEN OAKS LOOP W",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386719010",
"telephone_number": "662-228-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7075 GOLDEN OAKS LOOP W",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386719010",
"telephone_number": "662-228-0130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SAVANNAH",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-06",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.