NPIMap

Organization Active NPI

Family First Behavioral Health

  • Clinical Social Worker
  • Flora, MS
National Provider Identifier
1902140304
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C5492 Issued in MS
Legal business name
FAMILY FIRST BEHAVIORAL HEALTH
Practice address
4848 Main St
Flora, MS 39071-9515
Phone
(601) 923-6401
NPI assigned
Nov 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Evelyn T Davis, LCSW
Title
Ceo
Phone
(601) 923-6401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C5492 MS Primary

Addresses

Primary practice location

4848 Main St
Flora, MS 39071-9515

Mailing address

434 Sylvan TRL
Clinton, MS 39056-2001
Phone (601) 923-6401

National Provider Directory

National Provider Directory

Locations

4848 Main St
Flora, MS 39071
Phone (601) 923-6401

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1902140304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 SYLVAN TRL",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390562001",
            "telephone_number": "601-923-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 MAIN ST",
            "city": "FLORA",
            "state": "MS",
            "postal_code": "390719515",
            "telephone_number": "601-923-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FIRST BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-923-6401",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C5492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flora, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.