Tarishan Winder

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

PA00335 Issued in MS

Practice address

340 Stateline Rd W
Southaven, MS 38671-1610

Phone

(662) 510-5980

NPI assigned

Apr 6, 2021

Last updated

Apr 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1912586033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 TALISKER DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160154",
            "telephone_number": "662-910-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711610",
            "telephone_number": "662-510-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDER",
        "first_name": "TARISHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "PA00335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan William Wilson, O.D.
• Leslie Diane Wilson, PT
• Savannah Wilson, MS
• Shirley Ann Wilson, PHD
• Amanda L Wiltshire, AGNP-C
• Anna Windham, LCSW
• Keith Alan Windsor
• With You Counseling Services, LLC
• Istvan David Wollak, M.D.
• Anthony Jerome Wood, NCC, LPC-S

• Addiction (Substance Use Disorder) Counselor in Southaven, MS
• Providers in Southaven, MS by specialty
• Addiction (Substance Use Disorder) Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.