NPIMap

Organization Active NPI

Region IV Elderly Outpatient Psychosocial Desoto

  • Community/Behavioral Health Agency
  • Southaven, MS
National Provider Identifier
1659786887
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
REGION IV ELDERLY OUTPATIENT PSYCHOSOCIAL DESOTO
Practice address
915 Ferncliff CV
Suite 1a
Southaven, MS 38671-2420
Phone
(662) 449-1971
Fax
(662) 449-1974
NPI assigned
Jun 26, 2014
Last updated
Jun 26, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
REGION IV MENTAL HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Authorized official

Name
Mr. Charlie D Spearman Sr.
Title
Executive Director
Phone
(662) 287-9883

Specialties & licenses 1

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

Addresses

Primary practice location

915 Ferncliff CV
Suite 1a
Southaven, MS 38671-2420

Mailing address

PO Box 839
Corinth, MS 38835-0839
Phone (662) 286-9883

National Provider Directory

National Provider Directory
Tax ID family
Region IV Mental Health Services Crisis Center-Corinth31 organizations share this tax ID, including this one
Part of
Region IV Mental Health Services Crisis Center-Corinth

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

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": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1659786887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350839",
            "telephone_number": "662-286-9883",
            "fax_number": "662-284-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 FERNCLIFF CV",
            "address_2": "SUITE 1A",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712420",
            "telephone_number": "662-449-1971",
            "fax_number": "662-449-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGION IV ELDERLY OUTPATIENT PSYCHOSOCIAL DESOTO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGION IV MENTAL HEALTH SERVICES",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "SPEARMAN",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "662-287-9883",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.