Psychosocial Boutique, PLLC.

Primary specialty

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

Legal business name

PSYCHOSOCIAL BOUTIQUE, PLLC.

Practice address

1751 Dancy Blvd
Horn Lake, MS 38637-1916

Phone

(662) 892-2660

NPI assigned

Aug 14, 2019

Last updated

Nov 29, 2025By 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

Dr. Syrenia Johnson, LCSWNPI 1598113482

Title

Owner/Practitioner

Phone

(662) 892-2660

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Syrenia Johnson, LCSW

  • Clinical Social Worker
  • Horn Lake, MS
  • NPI 1598113482
  Medicare reassignment Authorized official
• Tatayana Hughes, LMSW, CMHT

  • Clinical Social Worker
  • Grenada, MS
  • NPI 1184411548
  NPD

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764374400000",
    "number": "1841846904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SUNSET DR STE D",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014079",
            "telephone_number": "662-892-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 DANCY BLVD",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371916",
            "telephone_number": "662-892-2660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Sunset Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Grenada",
            "state": "MS",
            "postal_code": "389014079",
            "country_code": "US",
            "telephone_number": "662-892-2660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "144 S Thomas St Ste 211",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388015331",
            "country_code": "US",
            "telephone_number": "662-892-2660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHOSOCIAL BOUTIQUE, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2025-11-29",
        "certification_date": "2025-11-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SYRENIA",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "662-892-2660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Prince
• Professional Rehab
• Psychological Education Inc (PsychEd)
• Psychological Education Inc (PsychEd)
• Psychological Education Incorporated (PsychEd Inc.)
• Tiffany Shannon Ray, CRNA
• Katherine Reece, DDS
• Brian Darrel Rhoads, DDS
• Arthur Thomas Roach, P.A.-C.
• Jacqueline Rueda, PT.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Horn Lake, MS
• Providers in Horn Lake, 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 Nov 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.