Mary Cecille Goysich, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

33538 Issued in MS

Practice address

4579 S Eason Blvd
Tupelo, MS 38801-6539

Phone

(662) 377-3161

Fax

(662) 377-2993

NPI assigned

Jun 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1508804626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E PRESIDENT AVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015599",
            "telephone_number": "662-377-4685",
            "fax_number": "662-377-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016539",
            "telephone_number": "662-377-3161",
            "fax_number": "662-377-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOYSICH",
        "first_name": "MARY",
        "middle_name": "CECILLE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "33538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117696",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesley Ann Gordon
• Santrise Goree, M.D.
• Spencer Goree
• Kimberly Faye Goss, FNP-C
• Judith Ann Govatos, RN
• Grace Abounds Home Care
• Gracie PLLC
• Justin C. Graff, M.D.
• Taylor Craven Graham, OTA
• Tracy Graham, O.T.

• Psychologist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.