Restoration House Counseling

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

RESTORATION HOUSE COUNSELING

Practice address

615 W Pine St
Hattiesburg, MS 39401-3835

Phone

(601) 336-9131

NPI assigned

Mar 19, 2021

Last updated

Dec 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Baker SheridanNPI 1962019745

Title

Owner

Phone

(601) 336-9131

Specialties & licenses 4

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Baker Sheridan

  • Clinical Social Worker
  • Hattiesburg, MS
  • NPI 1962019745
  NPD Authorized official
• Alexis Bailey, MS

  • Mental Health Counselor
  • Hattiesburg, MS
  • NPI 1356186530
  NPD
• Olivia Hogan Ismail, LCSW

  • Clinical Social Worker
  • Hattiesburg, MS
  • NPI 1841952306
  NPD
• Richard Sheridan

  • Mental Health Counselor
  • Hattiesburg, MS
  • NPI 1790414001
  NPD

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1497331508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013835",
            "telephone_number": "601-336-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013835",
            "telephone_number": "601-336-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HOUSE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BAKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-336-9131"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Respire Health LLC
• Retina Specialists of Mississippi, PLLC
• D Enise W Reynolds, M.D.
• Deidre Reynolds, PHARMD
• Katherine Elizabeth Reynolds, OD
• Kimberly Reynolds, PT, DPT

• Mental Health Counselor in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.