Pendleton Counseling Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PENDLETON COUNSELING CENTER

Practice address

403 Old Town Cir
Brandon, MS 39042-3628

Phone

(601) 201-4111

Fax

(601) 825-1793

NPI assigned

Oct 20, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Linda Faye Pendleton

Title

Licensed Clinical Social Worker

Phone

(601) 201-4111

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pendleton Counseling Center Doing business as

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1548869712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 OLD TOWN CIR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423628",
            "telephone_number": "601-201-4111",
            "fax_number": "601-825-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 OLD TOWN CIR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423628",
            "telephone_number": "601-201-4111",
            "fax_number": "601-825-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDLETON COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "601-201-4111",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06635891",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pendleton Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberley J Paul, LCSW
• Constance Wheatley Payne, PHARMD
• PB Mississippi Health Services, LLC
• Lauren Callie Peace
• Peak Therapy LLC
• Kayla Roseanna Pendleton
• Linda Faye Pendleton, LCSW
• Perry Sanderford PLLC
• Gloria Mangum Perry, M.D.
• Whitany D Perry

• Clinical Social Worker in Brandon, MS
• Providers in Brandon, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.