Individual provider Active NPI

Kathryn Wright, LPC

  • Professional Counselor
  • Vicksburg, MS
National Provider Identifier
1689059537
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2015 Issued in MS
Practice address
1414 Cherry St
Vicksburg, MS 39180-3218
Phone
(601) 636-5703
Fax
(601) 636-5739
NPI assigned
Jul 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2015 MS Primary

Addresses

Primary practice location

1414 Cherry St
Vicksburg, MS 39180-3218

Mailing address

1414 Cherry St
Vicksburg, MS 39180-3218
Phone (601) 636-5703

Other identifiers 1

IdentifierTypeStateIssuer
2015OtherMSMISSISSIPPI BOARD OF EXAMINERS FOR LICENSED PROFESSIONAL COUNSELORS

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
I20240130002995 MS Practitioner - Mental Health Counselor 7416300066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grace Christian Counseling CenterGroup PAC ID 0749285070, 5 clinicians

Practice addresses (Care Compare)

1414 Cherry St
Vicksburg, MS 39180-3218
Phone (601) 636-5703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Christian Counseling Center Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

1414 Cherry St
Vicksburg, MS 39180
Phone (601) 636-5703

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1689059537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 CHERRY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803218",
            "telephone_number": "601-636-5703",
            "fax_number": "601-636-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CHERRY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803218",
            "telephone_number": "601-636-5703",
            "fax_number": "601-636-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI BOARD OF EXAMINERS FOR LICENSED PROFESSIONAL COUNSELORS",
            "identifier": "2015",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.