Individual provider Active NPI

Miriam Bond

  • Mental Health Counselor
  • Vicksburg, MS
National Provider Identifier
1366864134
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3444 Wisconsin Ave
Vicksburg, MS 39180-5331
Phone
(630) 638-0031
NPI assigned
Jan 14, 2014
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

3444 Wisconsin Ave
Vicksburg, MS 39180-5331

Mailing address

3444 Wisconsin Ave
Vicksburg, MS 39180-5331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515000754 MS Practitioner - Clinical Social Worker 1153762612 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

1727 E Union St
Greenville, MS 38703-3253
Phone (662) 537-4830

1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MDB Care Management LLC CurrentSince Dec 8, 2025 Accepting new patients
Minor Med Care, LLC CurrentSince Dec 8, 2025 Accepting new patients
Uppal Medical Center LLC CurrentSince Dec 8, 2025 Accepting new patients
Minor Med Care, LLC CurrentSince Dec 8, 2025 Accepting new patients
MDB Behavioral Health Services LLC CurrentSince May 1, 2024 Accepting new patients

Locations

1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373

215 Katherine Dr
#A
Jackson, MS 39232

2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1366864134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 WISCONSIN AVE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 WISCONSIN AVE",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805331",
            "telephone_number": "630-638-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOND",
        "first_name": "MIRIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.