Active NPI
New Direction Therapeutic Group Home
Doing business as New Direction
- Professional Counselor
- Jackson, MS
National Provider Identifier
1609589266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- NEW DIRECTION THERAPEUTIC GROUP HOME
- Doing business as
- New Direction
- Practice address
- 362 E Northside Dr
Jackson, MS 39206-5456 - Phone
- (601) 519-1731
- NPI assigned
- Dec 28, 2022
- Last updated
- Dec 28, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Eddie Lee Jr.
- Title
- President/Ceo
- Phone
- (601) 209-2717
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NU | Primary |
Addresses
Primary practice location
362 E Northside Dr
Jackson, MS 39206-5456
Mailing address
5201 Cedar Park Dr
Jackson, MS 39206-4140
Phone (601) 982-1986
Other practice location 1
5201 Cedar Park Dr
Jackson, MS 39206-4140
Phone (601) 982-1986
Other names 1
- NEW DIRECTION
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
5201 Cedar Park Dr
Jackson, MS 39206
Phone (601) 982-1986
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.
-
- Social Worker
- Ridgeland, MS
- NPI 1619349909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672185600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1672185600000",
"number": "1609589266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5201 CEDAR PARK DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392064140",
"telephone_number": "601-982-1986",
"fax_number": "601-982-1986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "362 E NORTHSIDE DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392065456",
"telephone_number": "601-519-1731"
}
],
"practiceLocations": [
{
"address_1": "5201 Cedar Park Dr",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392064140",
"country_code": "US",
"telephone_number": "601-982-1986",
"fax_number": "601-982-1986",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NEW DIRECTION THERAPEUTIC GROUP HOME",
"organizational_subpart": "NO",
"enumeration_date": "2022-12-28",
"last_updated": "2022-12-28",
"certification_date": "2022-12-28",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "EDDIE",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "601-209-2717",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "NEW DIRECTION",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.