NPIMap

Organization Active NPI

Psycamore, LLC

  • Clinic/Center
  • Flowood, MS
National Provider Identifier
1699090001
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
DCS-PSYCAMORE-PHA/OP Issued in MS
Legal business name
PSYCAMORE, LLC
Practice address
2540 Flowood Dr
Flowood, MS 39232-9362
Phone
(601) 939-5993
Fax
(601) 939-5935
NPI assigned
Mar 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Katherine A Hall, CMM
Title
Business Manager
Phone
(601) 939-5993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X DCS-PSYCAMORE-PHA/OP MS Primary

Addresses

Primary practice location

2540 Flowood Dr
Flowood, MS 39232-9362

Mailing address

2540 Flowood Dr
Flowood, MS 39232-9362
Phone (601) 939-5993

Other names 1

  • Psycamore Professional Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Psycamore Psychiatric Programs LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1699090001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329362",
            "telephone_number": "601-939-5993",
            "fax_number": "601-939-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 FLOWOOD DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329362",
            "telephone_number": "601-939-5993",
            "fax_number": "601-939-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCAMORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "601-939-5993",
        "authorized_official_credential": "CMM"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "DCS-PSYCAMORE-PHA/OP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psycamore Professional Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.