| Region Vi Community Mental Health Commission | |
|
2504 Browning Road Greenwood MS 38930 | |
| (662) 453-6211 | |
| (662) 455-8724 |
| Full Name | Region Vi Community Mental Health Commission |
|---|---|
| Speciality | Clinic/Center |
| Location | 2504 Browning Road, Greenwood, Mississippi |
| Authorized Official Name and Position | Phaedre Cole (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6624536211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Region Vi Community Mental Health Commission Po Box 1505 Greenwood MS 38935-1505 Ph: (662) 453-6211 | Region Vi Community Mental Health Commission 2504 Browning Road Greenwood MS 38930 Ph: (662) 453-6211 |
| NPI Number | 1154433233 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 10/06/2020 |
| Certification Date | 10/06/2020 |
| Medicare PECOS PAC ID | 0749183663 |
|---|---|
| Medicare Enrollment ID | O20040129000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154433233 | NPI | - | NPPES |
| 00770318 | Medicaid | MS | |
| 00770409 | Medicaid | MS | |
| 09581272 | Medicaid | MS | |
| 01253876 | Medicaid | MS | |
| 00018206 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Mississippi) | Primary |
| Provider Name | Clyde E Glenn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982612164 PECOS PAC ID: 5597667964 Enrollment ID: I20040128000368 |
| Provider Name | Catherine Kidd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295914810 PECOS PAC ID: 7214822048 Enrollment ID: I20040219000469 |
| Provider Name | Joseph A Kwentus |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1477582096 PECOS PAC ID: 3678567245 Enrollment ID: I20040414001441 |
| Provider Name | Khaled N Abu-hamdan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356482459 PECOS PAC ID: 1456341221 Enrollment ID: I20040513001254 |
| Provider Name | Debra E Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083653257 PECOS PAC ID: 8820048606 Enrollment ID: I20050128000826 |
| Provider Name | Maxie Lerone Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427018613 PECOS PAC ID: 2466406798 Enrollment ID: I20050309000456 |
| Provider Name | Vernon Thomas Hughes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427073170 PECOS PAC ID: 5890713416 Enrollment ID: I20051102000811 |
| Provider Name | Raymundo C Trinanes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487727095 PECOS PAC ID: 9335246727 Enrollment ID: I20070518000530 |
| Provider Name | Chandra A Boston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043249295 PECOS PAC ID: 3779654041 Enrollment ID: I20080612000885 |
| Provider Name | Kenny N Terry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902991706 PECOS PAC ID: 2668569914 Enrollment ID: I20081001000467 |
| Provider Name | Maurice Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558393843 PECOS PAC ID: 7517126360 Enrollment ID: I20120314000215 |
| Provider Name | Joyce C Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053681213 PECOS PAC ID: 8527228162 Enrollment ID: I20120320000164 |
| Provider Name | Douglas Cole |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255458444 PECOS PAC ID: 3870753684 Enrollment ID: I20120330000584 |
| Provider Name | Shonda Jacqueline R Phelon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194947754 PECOS PAC ID: 8527223627 Enrollment ID: I20120622000025 |
| Provider Name | Charles S Small |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871848952 PECOS PAC ID: 4284880741 Enrollment ID: I20120816000131 |
| Provider Name | Carolyn V Tingle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700975984 PECOS PAC ID: 4688806086 Enrollment ID: I20140417001930 |
| Provider Name | April L Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528303294 PECOS PAC ID: 1153549845 Enrollment ID: I20140821000488 |
| Provider Name | James G Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396964631 PECOS PAC ID: 8325362163 Enrollment ID: I20150127000017 |
| Provider Name | Billy R Walton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871980995 PECOS PAC ID: 1759693377 Enrollment ID: I20150709002251 |
| Provider Name | Rona Kaye Huey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992163588 PECOS PAC ID: 6709177454 Enrollment ID: I20160628000354 |
| Provider Name | Krisna A Hervey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689046104 PECOS PAC ID: 1850684556 Enrollment ID: I20160718001871 |
| Provider Name | Kwanza Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932566742 PECOS PAC ID: 1951699412 Enrollment ID: I20161017000633 |
| Provider Name | Carleen Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124562871 PECOS PAC ID: 0547545659 Enrollment ID: I20170331000770 |
| Provider Name | Martha Catlette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275073157 PECOS PAC ID: 6608152178 Enrollment ID: I20170418000536 |
| Provider Name | Lawanda Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740791722 PECOS PAC ID: 1850647389 Enrollment ID: I20180726002212 |
| Provider Name | Roxie Hogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144780826 PECOS PAC ID: 3375873631 Enrollment ID: I20190930001207 |
| Provider Name | Carolyn Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669975587 PECOS PAC ID: 1456244524 Enrollment ID: I20200212000315 |
| Provider Name | Ryginna Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245871417 PECOS PAC ID: 6507292323 Enrollment ID: I20200213002671 |
| Provider Name | Emily Burroughs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538770409 PECOS PAC ID: 8123424793 Enrollment ID: I20210907002072 |
| Provider Name | Bobbi J Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063028512 PECOS PAC ID: 7416307111 Enrollment ID: I20231221000168 |
| Provider Name | Diania D Mims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598469066 PECOS PAC ID: 6305296021 Enrollment ID: I20231221000741 |
Greenwood Leflore Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1317 River Rd, Greenwood, MS 38930 Phone: 662-459-2520 | |
Region 6 Community Mental Health Commission Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Browning Road 520, Greenwood, MS 38930 Phone: 662-453-6211 Fax: 662-453-2558 | |
Westminster Presbyterian Church Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 E Park Ave, Greenwood, MS 38930 Phone: 662-451-9943 | |
Life Help Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Browning Road 520, Greenwood, MS 38930 Phone: 662-453-6211 | |
Greenwood Leflore Hospital Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 River Rd, Greenwood, MS 38930 Phone: 662-459-7149 Fax: 662-459-1159 | |
Life Help Industries Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Browning Road 520, Greenwood, MS 38930 Phone: 662-453-6211 Fax: 662-455-8724 |