Elite Psychiatric Services PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ELITE PSYCHIATRIC SERVICES PLLC

Practice address

357 Towne Center PL Ste 400
Ridgeland, MS 39157-4844

Phone

(888) 561-3380

Fax

(888) 732-6141

NPI assigned

Mar 27, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Shakevia Johnson, MDNPI 1104236850

Title

Owner/Psychiatrist

Phone

(662) 392-1669

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shakevia V. Johnson, M.D.

  • Psychiatry Physician
  • Boston, MA
  • NPI 1104236850
  NPD Authorized official
• Sequoyah Sherrill

  • Mental Health Counselor
  • Catonsville, MD
  • NPI 1831616481
  NPD

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1467155697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 COUNTY ROAD 71",
            "city": "MC CARLEY",
            "state": "MS",
            "postal_code": "389439305",
            "telephone_number": "662-392-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 TOWNE CENTER PL STE 400",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574844",
            "telephone_number": "888-561-3380",
            "fax_number": "888-732-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHAKEVIA",
        "authorized_official_title_or_position": "OWNER/PSYCHIATRIST",
        "authorized_official_telephone_number": "662-392-1669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.