Mequandra Twillie, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

M10702 Issued in MS

Practice address

5192 Highway 11 N
Ellisville, MS 39437-5050

Phone

(601) 649-7921

Fax

(601) 649-7939

NPI assigned

Oct 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Region 12 Commission on Mental Health & Retardation Pine Belt Men

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hattiesburg, MS
  • NPI 1982610572
  NPD (past)

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1689446346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18679",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394048679",
            "telephone_number": "601-705-1901",
            "fax_number": "601-705-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5192 HIGHWAY 11 N",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394375050",
            "telephone_number": "601-649-7921",
            "fax_number": "601-649-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWILLIE",
        "first_name": "MEQUANDRA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M10702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kourtni Strong, CMHT
• Stephen L Surber, DMD
• Walton Frank Therrell, R.PH.
• Stacy Therrell Thrash, PHARM,D,
• Patricia A. Tibbs, M.D.
• Sheila Vickers, IDD WAIVER SERVICES
• Walgreen Co
• Nikki Red Walters
• Rebekah Walters
• Jessie Watson, CPNP

• All providers in Ellisville, MS
• Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.