Individual provider Active NPI

Adrienne Deanette Carlisle, LPC

  • Counselor
  • Hattiesburg, MS
National Provider Identifier
1992977821
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1303 Issued in MS
Practice address
103 S 19TH Ave
Hattiesburg, MS 39401-6171
Phone
(601) 544-4222
Fax
(601) 584-4053
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1303 MS Primary

Addresses

Primary practice location

103 S 19TH Ave
Hattiesburg, MS 39401-6171

Mailing address

103 S 19TH Ave
Hattiesburg, MS 39401-6171
Phone (601) 544-4222

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1303MSMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1992977821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S 19TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016171",
            "telephone_number": "601-544-4222",
            "fax_number": "601-584-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S 19TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016171",
            "telephone_number": "601-544-4222",
            "fax_number": "601-584-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "ADRIENNE",
        "middle_name": "DEANETTE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "1303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.