Individual provider Active NPI

Anne Overton Earwood, MA

  • Counselor
  • Jackson, MS
National Provider Identifier
1942950860
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
P-0683 Issued in MS
Practice address
4500 I 55 N Ste 279
Jackson, MS 39211-5981
Phone
(769) 232-8845
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X P-0683 MS Primary

Addresses

Primary practice location

4500 I 55 N Ste 279
Jackson, MS 39211-5981

Mailing address

4440 Audubon Park Dr
Jackson, MS 39211-6137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 10, 2024 through Jul 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
P-0683MSMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1942950860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 AUDUBON PARK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 I 55 N STE 279",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115981",
            "telephone_number": "769-232-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARWOOD",
        "first_name": "ANNE",
        "middle_name": "OVERTON",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "P-0683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.