Active NPI
Anna Davis Mahaffey
- Professional Counselor
- Oxford, MS
National Provider Identifier
1811453301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2617
- Practice address
- 308 Enterprise Dr
Oxford, MS 38655-2944 - Phone
- (662) 380-5110
- NPI assigned
- Feb 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2617 | MS | Primary |
Addresses
Primary practice location
308 Enterprise Dr
Oxford, MS 38655-2944
Mailing address
703 Battle LN
Oxford, MS 38655-8062
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 22, 2024 through Jul 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2617 | MS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1811453301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 BATTLE LN",
"city": "OXFORD",
"state": "MS",
"postal_code": "386558062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 ENTERPRISE DR",
"city": "OXFORD",
"state": "MS",
"postal_code": "386552944",
"telephone_number": "662-380-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAFFEY",
"first_name": "ANNA",
"middle_name": "DAVIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-20",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "2617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxford, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.