Michael Kincade, LCAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0103 Issued in MS

Practice address

3 Clearview Cir
Moselle, MS 39459-9520

Phone

(601) 544-1499

Fax

(601) 544-8464

NPI assigned

Mar 22, 2012

Sex

Male

Sole proprietor

No

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 12 Commission on Mental Health and Retardation

  • Substance Abuse Rehabilitation Facility
  • Moselle, MS
  • NPI 1982612206
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 22, 2012.

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1942576012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18679",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394048679",
            "telephone_number": "601-705-1901",
            "fax_number": "601-705-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CLEARVIEW CIR",
            "city": "MOSELLE",
            "state": "MS",
            "postal_code": "394599520",
            "telephone_number": "601-544-1499",
            "fax_number": "601-544-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCADE",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "0103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Craft, CPSS
• Grayson Creek Medical Clinic, LLC
• Stephanie Harris, CPSS
• Lauryn Hicks, FNP-C
• Heather Holifield, PCAT
• Mack E Knight, FNP-C
• Mississippi Baptist Ministry for Children and Families Inc
• Mississippi Baptist Ministry Inc
• Mississippi Baptist Ministry Inc
• Christy Oberst, LPC

• All providers in Moselle, MS
• Addiction (Substance Use Disorder) Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.