Individual provider Active NPI

Carly Elizabeth Jergins

  • Mental Health Counselor
  • Brookhaven, MS
National Provider Identifier
1487564522
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P-1619 Issued in MS
Practice address
725 Brookman Dr Ext
Brookhaven, MS 39601-2311
Phone
(601) 823-2300
NPI assigned
Sep 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P-1619 MS Primary

Addresses

Primary practice location

725 Brookman Dr Ext
Brookhaven, MS 39601-2311

Mailing address

2706 Highway 583 SE
Bogue Chitto, MS 39629-9634
Phone (601) 823-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1487564522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 HIGHWAY 583 SE",
            "city": "BOGUE CHITTO",
            "state": "MS",
            "postal_code": "396299634",
            "telephone_number": "601-823-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BROOKMAN DR EXT",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012311",
            "telephone_number": "601-823-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERGINS",
        "first_name": "CARLY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "P-1619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.