Desoto Wellness Clinic LLC
Organization Active NPI Addiction (Substance Use Disorder) Counselor · Southaven, MS
NPI 1750051173 · NPPES record last updated Sep 16, 2021
Key facts
- NPI
- 1750051173
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Legal business name
- DESOTO WELLNESS CLINIC LLC
- Practice address
- 8829 Centre St Ste 100
Southaven, MS 38671-2610 - Phone
- (662) 934-8671
- NPI assigned
- Sep 16, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Cedric Edwards, MD
- Title
- Medical Director
- Phone
- (662) 934-8671
Practitioners 1
-
Cedric Edwards, M.D.
National Provider Directory
Locations
8829 Centre St
Ste 100
Southaven, MS 38671
Phone (601) 342-5991
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | Yes | ||
| Clinical Social Worker |
1041C0700X |
Addresses
Primary practice location
8829 Centre St Ste 100
Southaven, MS 38671-2610
Mailing address
222 Southlakes Dr
Grenada, MS 38901-8499
Phone (662) 934-8671
Other providers in Southaven, MS
- Desoto Osteopathic
- Desoto Surgery Clinic LLC
- Desoto Therapy, Inc.
- Desoto Thyroid and Endocrinology
- Desoto Urgent Care Clinic, LLC
- Desoto Womens Care Center, PLLC
- Kayla Desutter
- Brandon Deterding
- Tyrel Detweiler
- Mahfuz Mahin Dewan
All providers in Southaven, MS · Addiction (Substance Use Disorder) Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.