NPIMap

Organization Active NPI

Imani Community Outreach Center

  • Social Worker
  • Kosciusko, MS
National Provider Identifier
1467728360
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
W7478 Issued in MS
Legal business name
IMANI COMMUNITY OUTREACH CENTER
Practice address
301 E Jefferson St
Kosciusko, MS 39090-3719
Phone
(662) 289-7676
NPI assigned
Mar 26, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Tricia Duncan
Title
Biller
Phone
(601) 878-6945

National Provider Directory

National Provider Directory
Tax ID family
Imani Community Outreach Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

301 E Jefferson St
Kosciusko, MS 39090
Phone (662) 289-7676

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X W7478 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

301 E Jefferson St
Kosciusko, MS 39090-3719

Mailing address

301 E Jefferson St
Kosciusko, MS 39090-3719
Phone (662) 289-7676

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2012.

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332720000000",
    "number": "1467728360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E JEFFERSON ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903719",
            "telephone_number": "662-289-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E JEFFERSON ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903719",
            "telephone_number": "662-289-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMANI COMMUNITY OUTREACH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-03-26",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "601-878-6945"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MS",
            "license": "W7478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kosciusko, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; 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.