NPIMap

Organization Active NPI

Pendleton Counseling Center

  • Clinical Social Worker
  • Brandon, MS
National Provider Identifier
1548869712
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PENDLETON COUNSELING CENTER
Doing business as
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
Last updated
Oct 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Dr. Linda Faye PendletonNPI 1922377662
Title
Licensed Clinical Social Worker
Phone
(601) 201-4111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

403 Old Town Cir
Brandon, MS 39042-3628

Mailing address

403 Old Town Cir
Brandon, MS 39042-3628
Phone (601) 201-4111

Other names 1

  • Pendleton Counseling Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pendleton Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, MS

Sources for this page

  • 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.