Individual provider Active NPI

Judith Olson, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Beach, MS
National Provider Identifier
1386489201
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
907247 Issued in MS
Practice address
4013 Beatline Rd Ste a
Long Beach, MS 39560-4135
Phone
(228) 200-0720
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 907247 MS Primary
Case Management Registered Nurse 163WC0400X 912579 MS

Addresses

Primary practice location

4013 Beatline Rd Ste a
Long Beach, MS 39560-4135

Mailing address

5107 Beatline Rd
Ste 100B Box#25
Long Beach, MS 39560-3867
Phone (228) 262-9886

Other practice location 1

4011 Beatline Rd
Long Beach, MS 39560-4137
Phone (228) 262-9886

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250305000049 MS Practitioner - Nurse Practitioner 3971024100 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
912579MSMDCase Management Registered Nurse
907247MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Clinic LLC CurrentSince Feb 27, 2025 Accepting new patients

Locations

4013 Beatline Rd
#A
Long Beach, MS 39560
Phone (228) 200-0720

4011 Beatline Rd
Ste 7
Long Beach, MS 39560
Phone (228) 200-0720

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Safe Harbor Clinic LLC 6 clinicians

Practice addresses (Care Compare)

4013 Beatline Rd
Suite a
Long Beach, MS 39560-4135
Phone (228) 200-0720

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1386489201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 BEATLINE RD",
            "address_2": "STE 100B BOX#25",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395603867",
            "telephone_number": "228-262-9886",
            "fax_number": "228-256-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 BEATLINE RD STE A",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604135",
            "telephone_number": "228-200-0720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4011 Beatline Rd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "MS",
            "postal_code": "395604137",
            "country_code": "US",
            "telephone_number": "228-262-9886",
            "fax_number": "228-256-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JUDITH",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "907247",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MS",
            "license": "912579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, MS

Sources for this page

Verify at the official NPI Registry.