Organization Active NPI

One Hope, LLC

  • Intellectual & Developmental Disabilities Psychologist
  • Clinton, MS
National Provider Identifier
1467987701
Registry record updated Jun 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Legal business name
ONE HOPE, LLC
Practice address
2 Dove Way Cir
Clinton, MS 39056-3589
Phone
(601) 201-6862
NPI assigned
Apr 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2022

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

Authorized official

Name
Adooree Michelle Tullar
Title
Executive Director
Phone
(769) 241-5146

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X Primary
Community/Behavioral Health Agency 251S00000X MS

Addresses

Primary practice location

2 Dove Way Cir
Clinton, MS 39056-3589

Mailing address

1896 Hwy. 471
Brandon, MS 39047
Phone (769) 241-5146

Other identifiers 2

IdentifierTypeStateIssuer
06354818MedicaidMS
0898306MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
One Hope2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654387200000",
    "number": "1467987701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1896 HWY. 471",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39047",
            "telephone_number": "769-241-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DOVE WAY CIR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563589",
            "telephone_number": "601-201-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE HOPE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-24",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A",
        "authorized_official_last_name": "TULLAR",
        "authorized_official_first_name": "ADOOREE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "769-241-5146"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06354818",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0898306",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; 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.