| Mellow Minds Behavioral Health Wellness & Counseling Center | |
|
225 Community Dr Fayette MS 39069-7701 | |
| (601) 809-0500 | |
| Not Available |
| Full Name | Mellow Minds Behavioral Health Wellness & Counseling Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 225 Community Dr, Fayette, Mississippi |
| Authorized Official Name and Position | Robin Williams-bailey (CEO/OWNER) |
| Authorized Official Contact | 6013178181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mellow Minds Behavioral Health Wellness & Counseling Center Po Box 2422 Fayette MS 39069-2422 Ph: (601) 317-8181 | Mellow Minds Behavioral Health Wellness & Counseling Center 225 Community Dr Fayette MS 39069-7701 Ph: (601) 809-0500 |
| NPI Number | 1225794902 |
|---|---|
| Provider Enumeration Date | 11/16/2021 |
| Last Update Date | 11/16/2021 |
| Certification Date | 11/16/2021 |
| Medicare PECOS PAC ID | 4981095973 |
|---|---|
| Medicare Enrollment ID | O20211230000949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225794902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Robin Shanta Williams-bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073022158 PECOS PAC ID: 9335495480 Enrollment ID: I20211230001073 |
Jefferson County Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 870 South Main Street, Fayette, MS 39069 Phone: 601-786-3401 Fax: 601-786-3400 | |
Jefferson County Hospital Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 Main St, Fayette, MS 39069 Phone: 601-786-3401 Fax: 601-786-3400 | |
Medgar Evers Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 Gilchrist St., Fayette, MS 39069 Phone: 601-786-3955 |