| Mississippi State University | |
|
223 Famous Maroon Band Street Mississippi State MS 39762 | |
| (662) 325-0621 | |
| (662) 325-0895 |
| Full Name | Mississippi State University |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 223 Famous Maroon Band Street, Mississippi State, Mississippi |
| Authorized Official Name and Position | Daniel Todd Hale (DIRECTOR, FISCAL OPERATIONS, STUDEN) |
| Authorized Official Contact | 6623255895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi State University Po Box 6124 Mississippi State MS 39762-6124 Ph: (662) 325-0621 | Mississippi State University 223 Famous Maroon Band Street Mississippi State MS 39762 Ph: (662) 325-0621 |
| NPI Number | 1518747567 |
|---|---|
| Provider Enumeration Date | 10/05/2023 |
| Last Update Date | 12/05/2025 |
| Certification Date | 12/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518747567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |