NPIMap

Organization Active NPI

Southern Communities Behavioral Health

  • Counselor
  • Port Gibson, MS
National Provider Identifier
1477048791
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2212 Issued in MS
Legal business name
SOUTHERN COMMUNITIES BEHAVIORAL HEALTH
Practice address
402 Greenwood St
Port Gibson, MS 39150-2626
Phone
(601) 448-5171
NPI assigned
Jun 28, 2018
Last updated
Jun 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Jonathan Reeves
Title
Owner
Phone
(630) 379-6755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2212 MS Primary

Addresses

Primary practice location

402 Greenwood St
Port Gibson, MS 39150-2626

Mailing address

PO Box 78
Port Gibson, MS 39150-0078

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1477048791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391500078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 GREENWOOD ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502626",
            "telephone_number": "601-448-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COMMUNITIES BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-379-6755"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "2212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Gibson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.