Raven Dashaun Thomas

Individual provider Active NPI Mental Health Counselor · Yazoo City, MS

NPI 1891404620 · NPPES record last updated Nov 21, 2022

Key facts

NPI
1891404620
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
635 W Willie Morris Pkwy
Yazoo City, MS 39194-7702
Phone
(662) 746-5712
NPI assigned
Nov 21, 2022
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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Yazoo Mental Health Service Current
since Nov 27, 2022
Accepting new patients

Locations

635 W Willie Morris Pkwy
Yazoo City, MS 39194
Phone (662) 746-5712

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

635 W Willie Morris Pkwy
Yazoo City, MS 39194-7702

Mailing address

635 W Willie Morris Pkwy
Yazoo City, MS 39194-7702
Phone (662) 746-5712

Other providers in Yazoo City, MS

All providers in Yazoo City, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.