| Joshua Blake Myrick, | |
|
613 Marquette Rd, Brandon, MS 39042-3038 | |
| (601) 824-1692 | |
| Not Available |
| Full Name | Joshua Blake Myrick |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 613 Marquette Rd, Brandon, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992440119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Mississippi) | Primary |
| Entity Name | Killebrew Psychological Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073988051 PECOS PAC ID: 8426330226 Enrollment ID: O20170130002648 |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua Blake Myrick, Po Box 88, Brandon, MS 39043-0088 Ph: (601) 824-1692 | Joshua Blake Myrick, 613 Marquette Rd, Brandon, MS 39042-3038 Ph: (601) 824-1692 |
Emily Lee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 613 Marquette Rd, Brandon, MS 39042 Phone: 601-824-1692 | |
Sky D Davenport, Counselor Medicare: Not Enrolled in Medicare Practice Location: 613 Marquette Rd, Brandon, MS 39042 Phone: 601-824-1692 | |
Tomeka Lafawn Bethea, Counselor Medicare: Not Enrolled in Medicare Practice Location: 613 Marquette Rd, Brandon, MS 39042 Phone: 601-824-1692 | |
Belinda Davis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 613 Marquette Rd, Brandon, MS 39042 Phone: 601-824-1692 | |
Mellani Maritza Wallace, Counselor Medicare: Not Enrolled in Medicare Practice Location: 613 Marquette Rd, Brandon, MS 39042 Phone: 601-591-5553 | |
William Cartier, Counselor Medicare: Not Enrolled in Medicare Practice Location: 408 Glen Oaks Dr, Brandon, MS 39047 Phone: 601-850-3288 | |
Talisa M Cox, Counselor Medicare: Not Enrolled in Medicare Practice Location: 613 Marquette Rd, Brandon, MS 39042 Phone: 601-824-1692 |