Individual provider Active NPI

Enda Huddleston

  • Counselor
  • Forest, MS
National Provider Identifier
1679283287
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2071 Highway 35 S Ste C
Forest, MS 39074-7838
Phone
(601) 469-2422
NPI assigned
Dec 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

2071 Highway 35 S Ste C
Forest, MS 39074-7838

Mailing address

860 E River PL Ste 100
Jackson, MS 39202-3442
Phone (601) 469-2422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1679283287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E RIVER PL STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023442",
            "telephone_number": "601-469-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 HIGHWAY 35 S STE C",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390747838",
            "telephone_number": "601-469-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "ENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.