Change Your World Mental Health Agency

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CHANGE YOUR WORLD MENTAL HEALTH AGENCY

Practice address

4807 N State St Ste 401
Jackson, MS 39206-4826

Phone

(601) 316-6163

NPI assigned

Dec 23, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Shirley Daniels

Title

Owner

Phone

(601) 316-6163

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1720476906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 N STATE ST STE 401",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064826",
            "telephone_number": "601-316-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 N STATE ST STE 401",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064826",
            "telephone_number": "601-316-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE YOUR WORLD MENTAL HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-316-6163",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• TL Chandler, PHD, LPC
• Arvind Chandrashekar
• Geraldine Chaney, MD
• Andrew Chang, MD
• Leo Liang-L Chang, M.D.
• Anne Roberson Chapman, FNP-BC
• Buffye L Chapman, SLP
• Jamaica Chapman, DNP
• Jasmin Chapman, DDS
• Michelle M Chapman, LPN

• Mental Health Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.