Illuminated Direction

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ILLUMINATED DIRECTION

Practice address

1903 Pass Rd
Biloxi, MS 39531-4119

Phone

(228) 209-9482

Fax

(601) 884-4466

NPI assigned

Aug 11, 2020

Last updated

Jan 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jonathan LacewellNPI 1851712137

Title

Owner

Phone

(919) 450-6446

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Illuminated Direction3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Illuminated Direction

  • Health Maintenance Organization
  • Durham, NC
  • NPI 1609286145
  NPD tax ID
• Illuminated Direction

  • Health Maintenance Organization
  • Springfield, VA
  • NPI 1780102335
  NPD tax ID

Locations

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.

• Jonathan Lacewell

  • Mental Health Counselor
  • Durham, NC
  • NPI 1851712137
  Authorized official Same address or phone

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1679184980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 PASS RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314119",
            "telephone_number": "228-209-9482",
            "fax_number": "601-884-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 PASS RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314119",
            "telephone_number": "228-209-9482",
            "fax_number": "601-884-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATED DIRECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "LACEWELL",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-450-6446",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06307760",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "infoms@idmindhealth.com",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1903 Pass Rd",
            "city": "Biloxi",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395314119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teraty Hudson, FNP-C
• Frank Hughes
• Donavan Huhn, PTA
• Vickie Ann Hurst, CRTT
• Justin M Hyde, R.D.
• Immediate Family Clinic
• Yashica R Inman
• Integrated Behavioral Health, PLLC (Integrated Behavioral Health Mississippi)
• Integrated Medical and Wellness Clinic of Mississippi LLC
• Iop Behavioral Health, LLC (IOP Behavioral Health, LLC Mississippi)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.