Individual provider Active NPI

Debra Ann Marshall

  • Social Worker
  • McComb, MS
National Provider Identifier
1427383199
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1701 White St
McComb, MS 39648-2711
Phone
(601) 684-2173
Fax
(601) 249-4234
NPI assigned
Oct 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MS Primary

Addresses

Primary practice location

1701 White St
McComb, MS 39648-2711

Mailing address

PO Box 768
McComb, MS 39649-0768
Phone (601) 684-2173

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
I20241004003704 MS Practitioner - Clinical Social Worker 3375074073 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Christian Counseling Center Social Worker CurrentSince Jul 25, 2024 Accepting new patients
SW Ms Mental Health Mental Retardation Commission Past Accepting new patients
Southwest Mississippi Mental Health Mental Retardation Commission Social Worker Past Accepting new patients

Locations

1414 Cherry St
Vicksburg, MS 39180
Phone (601) 636-5703

Organizations & group practices 3

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": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1427383199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490768",
            "telephone_number": "601-684-2173",
            "fax_number": "601-249-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WHITE ST",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482711",
            "telephone_number": "601-684-2173",
            "fax_number": "601-249-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.