| Region Seven Mental Health Intellectual Disabilities Comm | |
|
222 Mary Holmes Dr West Point MS 39773-4400 | |
| (662) 295-6433 | |
| (662) 323-5553 |
| Full Name | Region Seven Mental Health Intellectual Disabilities Comm |
|---|---|
| Speciality | Clinic/Center |
| Location | 222 Mary Holmes Dr, West Point, Mississippi |
| Authorized Official Name and Position | Kathy A Doss (ACCTS REC/BILLING SUPERVISOR) |
| Authorized Official Contact | 6622856433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Region Seven Mental Health Intellectual Disabilities Comm 1032 State Hwy 50 W West Point MS 39773 Ph: (662) 524-4347 | Region Seven Mental Health Intellectual Disabilities Comm 222 Mary Holmes Dr West Point MS 39773-4400 Ph: (662) 295-6433 |
| NPI Number | 1700894730 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 3072531953 |
|---|---|
| Medicare Enrollment ID | O20051109000565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700894730 | NPI | - | NPPES |
| 000018207 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | R07BR (Mississippi) | Primary |
| Provider Name | Kerry L Kokaisel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477500676 PECOS PAC ID: 7416951413 Enrollment ID: I20060906000213 |
| Provider Name | Akif A Khawaja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659381044 PECOS PAC ID: 1153328034 Enrollment ID: I20061107000486 |
| Provider Name | Alfredo Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164434882 PECOS PAC ID: 4284733916 Enrollment ID: I20071213000336 |
| Provider Name | Raymond G Overstreet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447350541 PECOS PAC ID: 3779771688 Enrollment ID: I20101220000470 |
| Provider Name | Dilyana Milev |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962693291 PECOS PAC ID: 8921322017 Enrollment ID: I20150120001946 |
| Provider Name | David Mathis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982636676 PECOS PAC ID: 9436107398 Enrollment ID: I20160824001503 |
| Provider Name | Keri D Victory-mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376191502 PECOS PAC ID: 8628300795 Enrollment ID: I20191023002276 |
| Provider Name | Tanika M Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669164935 PECOS PAC ID: 0042670457 Enrollment ID: I20230717003676 |
| Provider Name | Shaneika Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922623560 PECOS PAC ID: 6002267655 Enrollment ID: I20240108004258 |
| Provider Name | Whitney W Cox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932710902 PECOS PAC ID: 9335592096 Enrollment ID: I20240129004199 |
| Provider Name | Andrew G Levine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194050161 PECOS PAC ID: 0941643191 Enrollment ID: I20240205003794 |
| Provider Name | Veronica R Harrison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528737608 PECOS PAC ID: 8022452101 Enrollment ID: I20240216000977 |
| Provider Name | William W Hubbard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215161310 PECOS PAC ID: 7810349016 Enrollment ID: I20240418001692 |
| Provider Name | John A Mclendon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649542507 PECOS PAC ID: 3173975380 Enrollment ID: I20240418001847 |
| Provider Name | Keenyn R Wald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710598255 PECOS PAC ID: 7315389988 Enrollment ID: I20240528003307 |
Community Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 219 Wood St, West Point, MS 39773 Phone: 662-494-4066 Fax: 662-524-4364 | |
Golden Triangle Autism Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5721 Highway 45 Alt S, West Point, MS 39773 Phone: 662-435-5315 | |
Region Seven Mental Health Idd Commission Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 337 Court St, West Point, MS 39773 Phone: 662-494-7060 Fax: 662-494-7533 | |
Sally Kate Winters Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 N Division St, West Point, MS 39773 Phone: 662-494-4867 Fax: 662-494-0870 |