Kids Hub

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

KIDS HUB

Practice address

15 Millbranch Rd
Hattiesburg, MS 39402-1413

Phone

(601) 909-6294

NPI assigned

Jul 27, 2022

Organization subpart

No

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

Authorized official

Name

Didi Ellis

Title

Executive Director

Phone

(601) 909-6294

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robin Bixler, LPC

  • Professional Counselor
  • Hattiesburg, MS
  • NPI 1366190746
  NPD
• Baxter Rose Williams, LMSW

  • Social Worker
  • Hattiesburg, MS
  • NPI 1215786215
  NPD

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1710613294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MILLBRANCH RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021413",
            "telephone_number": "601-909-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MILLBRANCH RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021413",
            "telephone_number": "601-909-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS HUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "DIDI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-909-6294"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humza Shahid Khan
• Mirza Mashaal Khan, M.D.
• Mohammad Khan, PHARMD
• Mohammed Attaullah Khan, MD
• Faraneh Khotanifar
• Silje Aadnesen Killen, M.S.
• Kaylon Ann Kilpatrick
• Kim S. Havard, Ms CCC-SLP LLC
• Ronald Sung-Won Kim, PHARM.D.
• Sarah Burnham Kimbrough

• Adolescent and Children Mental Health Clinic/Center in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Adolescent and Children Mental Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.