Derrick A. High II – Counselor in Forest, MS

Key facts

NPI: 1942968003
Entity type: Individual (NPI type 1)
Primary specialty: Counselor 101Y00000X
Practice address: 2071 Highway 35 S Ste C
Forest, MS 39074-7838
Phone: (662) 516-8676
NPI assigned: Dec 6, 2021
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X			Yes

Addresses

Primary practice location

2071 Highway 35 S Ste C
Forest, MS 39074-7838

Mailing address

860 E River PL Ste 100
Jackson, MS 39202-3442

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 6, 2021.

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1942968003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E RIVER PL STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 HIGHWAY 35 S STE C",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390747838",
            "telephone_number": "662-516-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGH",
        "first_name": "DERRICK",
        "middle_name": "A.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, MS

All providers in Forest, MS · Counselor in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.