Rekeka Tate, MS

Key facts

NPI

1861997009

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

Practice address

16220 W Main St
Louisville, MS 39339-2639

Phone

(662) 773-9377

Fax

(662) 773-9025

NPI assigned

Mar 29, 2018

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Region Seven Mental Health Idd Commission Mental Health Clinic/Center (Including Community Mental Health Center) · Louisville, MS · NPI 1699891358
  NPD (past) MENTAL HEALTH

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 29, 2018.

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1861997009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N JACKSON ST",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592504",
            "telephone_number": "662-323-9318",
            "fax_number": "662-323-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 W MAIN ST",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393392639",
            "telephone_number": "662-773-9377",
            "fax_number": "662-773-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "REKEKA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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