Potters House Church

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

08930021 Issued in MS

Legal business name

POTTERS HOUSE CHURCH

Practice address

5913 Floral Dr
Jackson, MS 39206-2413

Phone

(601) 982-9692

Fax

(601) 952-0548

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Clara H Gray

Title

Director

Phone

(601) 896-5026

Specialties & licenses 1

Addresses

Other names 1

• MOLDING MINDS Doing business as

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1639506207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11303",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392831303",
            "telephone_number": "601-982-9692",
            "fax_number": "601-952-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5913 FLORAL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392062413",
            "telephone_number": "601-982-9692",
            "fax_number": "601-952-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTERS HOUSE CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "CLARA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-896-5026",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MS",
            "license": "08930021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOLDING MINDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Posey, NP-C
• Positive Growth & Wellness LLC
• Positive Living Inc
• Positive Living, Inc.
• Positive Pathways Behavioral Health: Treatment and Recovery, LLC
• Janskey Potts
• Denise Goodwin Pouncey, AU.D.
• Charles Pound, MD
• Christopher Powe, NP
• Marshall R Powe, LCSW

• Community/Behavioral Health Agency in Jackson, MS
• Providers in Jackson, MS by specialty
• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.