Sunnybrook Children'S Home, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SUNNYBROOK CHILDREN'S HOME, INC.

Practice address

222 Sunnybrook Rd
Ridgeland, MS 39157-2205

Phone

(769) 972-2934

Fax

(601) 856-6555

NPI assigned

Oct 30, 2019

Organization subpart

No

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

Authorized official

Name

Kenneth Spansel, LPCNPI 1558923391

Title

Program Director

Phone

(601) 856-6555

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kenneth Spansel, LPC

  • Professional Counselor
  • Ridgeland, MS
  • NPI 1558923391
  NPD (past) Authorized official

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1902440209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4871",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964871",
            "telephone_number": "601-856-6555",
            "fax_number": "601-856-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SUNNYBROOK RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572205",
            "telephone_number": "769-972-2934",
            "fax_number": "601-856-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYBROOK CHILDREN'S HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "SPANSEL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "601-856-6555",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.