Desiray Thomas
Individual provider Active NPI Professional Counselor · Petal, MS
NPI 1992637896 · NPPES record last updated Jun 2, 2026
Key facts
- NPI
- 1992637896
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 101534 (TX)
- Practice address
- 414 S George Ave
Petal, MS 39465-2028 - Phone
- (813) 764-3253
- NPI assigned
- Jun 2, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101534 | TX | MD | Pediatric Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 101534 | TX | Yes |
Addresses
Primary practice location
414 S George Ave
Petal, MS 39465-2028
Mailing address
414 S George Ave
Petal, MS 39465-2028
Other names
- Desiray Henderson
Other providers in Petal, MS
- Southeast Mississippi Rural Health Initiative, Inc.
- Southern Grace Services
- Speak Up Therapy, LLC
- Mallory Stockstill
- Terrace Hill Dental Center PLLC
- Mary E Thomsen
- Christina Francessca Thornton
- Wal-Mart Stores East LP
- Walgreen Co
- Walgreen Co
All providers in Petal, MS · Professional 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 Jun 2, 2026. 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.