Individual provider Active NPI

Paula Jean Allen, LPC

  • Mental Health Counselor
  • Olive Branch, MS
National Provider Identifier
1396203790
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2723 Issued in MS
Practice address
6810 Crumpler Blvd Ste 300
Olive Branch, MS 38654-1936
Phone
(901) 826-9653
NPI assigned
Mar 5, 2019
Last updated
Jun 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2723 MS
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X P-0539 MS
Mental Health Counselor 101YM0800X 88314 TX
Mental Health Counselor 101YM0800X 2723 MS Primary

Addresses

Primary practice location

6810 Crumpler Blvd Ste 300
Olive Branch, MS 38654-1936

Mailing address

6810 Crumpler Blvd Ste 300
Olive Branch, MS 38654-1936
Phone (901) 826-9653

Other identifiers 2

IdentifierTypeStateIssuer
W9443OtherMSMS BOARD OF SOCIAL WORKERS
200000450MedicaidMS

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
I20231204001848 MS Practitioner - Mental Health Counselor 9638527534 Practice locations: Olive Branch, MS

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6810 Crumpler Blvd
Suite 300
Olive Branch, MS 38654-1936
Phone (901) 826-9653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P-0539MSMDMental Health Counselor
88314TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1396203790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 CRUMPLER BLVD STE 300",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541936",
            "telephone_number": "901-826-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 CRUMPLER BLVD STE 300",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541936",
            "telephone_number": "901-826-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "PAULA",
        "middle_name": "JEAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "2723",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "P-0539",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "88314",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "2723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BOARD OF SOCIAL WORKERS",
            "identifier": "W9443",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000450",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.