Easter Seals Mississippi Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EASTER SEALS MISSISSIPPI INC.

Practice address

2901 S Eason Blvd
Tupelo, MS 38804-5945

Phone

(682) 432-2995

Fax

(817) 303-9274

NPI assigned

Sep 25, 2024

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carol Khoury

Title

Cfo

Phone

(662) 432-2995

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1740007129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388045945",
            "telephone_number": "682-432-2995",
            "fax_number": "817-303-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388045945",
            "telephone_number": "682-432-2995",
            "fax_number": "817-303-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS MISSISSIPPI INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-432-2995"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.