Organization Active NPI

Counseling and Mentoring Program

  • Community/Behavioral Health Agency
  • Jackson, MS
National Provider Identifier
1609164748
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNSELING AND MENTORING PROGRAM
Practice address
2964 Terry Road B-1
Jackson, MS 39212
Phone
(601) 371-6500
NPI assigned
Jul 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Authorized official

Name
Miss Danah Evans
Title
Administrator
Phone
(601) 371-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2964 Terry Road B-1
Jackson, MS 39212

Mailing address

2964 Terry Road B-1
Jackson, MS 39212
Phone (601) 371-6500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310342400000",
    "number": "1609164748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2964 TERRY ROAD B-1",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39212",
            "telephone_number": "601-371-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2964 TERRY ROAD B-1",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39212",
            "telephone_number": "601-371-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING AND MENTORING PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DANAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-371-6500",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.