Individual provider Active NPI

Rushie Clayton, LCSW

  • Clinical Social Worker
  • Laurel, MS
National Provider Identifier
1669290474
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C11255 Issued in MS
Practice address
3603 Sunrise Dr
Laurel, MS 39440-1661
Phone
(601) 577-5885
NPI assigned
Sep 30, 2024
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C11255 MS Primary

Addresses

Primary practice location

3603 Sunrise Dr
Laurel, MS 39440-1661

Mailing address

3603 Sunrise Dr
Laurel, MS 39440-1661
Phone (601) 577-5885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211000353 MS Practitioner - Clinical Social Worker 7618403858 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Alabama School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

1727 E Union St
Greenville, MS 38703-3253
Phone (662) 537-4830

1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C11255MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Minor Med Care, LLC CurrentSince Nov 1, 2024 Accepting new patients
Minor Med Care, LLC CurrentSince Nov 1, 2024 Accepting new patients
MDB Behavioral Health Services LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

215 Katherine Dr
#A
Jackson, MS 39232

2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1669290474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 SUNRISE DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401661",
            "telephone_number": "601-577-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3603 SUNRISE DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401661",
            "telephone_number": "601-577-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "RUSHIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C11255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.