Mary L Bozeman, CMHT
Individual provider Active NPI Mental Health Counselor · Vicksburg, MS
NPI 1457589780 · NPPES record last updated Jun 5, 2024
Key facts
- NPI
- 1457589780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 3444 Wisconsin Ave
Vicksburg, MS 39180-5331 - Phone
- (601) 638-0031
- NPI assigned
- Jun 25, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH5469 | MS | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CH5469 | MS | |
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
3444 Wisconsin Ave
Vicksburg, MS 39180-5331
Mailing address
11220 Road 723
Union, MS 39365-3456
Phone (662) 549-0140
Other names
- Mary Atkins
Other providers in Vicksburg, MS
- Karen Bourne
- Coty Bourque
- Courtney Boutwell
- Melissa Denise Bowman
- Rebecca Lauren Boyd
- Steven Brasfield
- Lynn Breeden
- Brent Thomas DMD PA
- Catherine Brent
- Laura Jeanne Briggs
All providers in Vicksburg, MS · Mental Health Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.