Shaunita Weathersby, CMHT
Individual provider Active NPI Mental Health Counselor · Richton, MS
NPI 1689389397 · NPPES record last updated Jan 17, 2023
Key facts
- NPI
- 1689389397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 5600 (MS)
- Practice address
- 91180 Highway 42
Richton, MS 39476-9254 - Phone
- (601) 788-6308
- Fax
- (601) 788-6349
- NPI assigned
- Jan 17, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5600 | MS | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5600 | MS | Yes |
Addresses
Primary practice location
91180 Highway 42
Richton, MS 39476-9254
Mailing address
PO Box 18679
Hattiesburg, MS 39404-8679
Phone (601) 705-1901
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- James Sawyer Williams
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All providers in Richton, MS · Mental Health Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.