| Region 12 Commission On Mental Health & Retardation Pine Belt Men | |
|
103 S 19th Ave Hattiesburg MS 39401-6171 | |
| (601) 544-4641 | |
| (601) 584-4053 |
| Full Name | Region 12 Commission On Mental Health & Retardation Pine Belt Men |
|---|---|
| Speciality | Clinic/Center |
| Location | 103 S 19th Ave, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Janet Mays (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6017051902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Region 12 Commission On Mental Health & Retardation Pine Belt Men Po Box 18679 Hattiesburg MS 39404-8679 Ph: (601) 705-1906 | Region 12 Commission On Mental Health & Retardation Pine Belt Men 103 S 19th Ave Hattiesburg MS 39401-6171 Ph: (601) 544-4641 |
| NPI Number | 1982610572 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 09/16/2015 |
| Medicare PECOS PAC ID | 3971561747 |
|---|---|
| Medicare Enrollment ID | O20041227000393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982610572 | NPI | - | NPPES |
| 00018212 | Medicaid | MS | |
| R121 | Other | MS | DMH CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | R12-1 (Mississippi) | Primary |
| Provider Name | Robbie Marie Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043227713 PECOS PAC ID: 3375580467 Enrollment ID: I20050411000565 |
| Provider Name | Richard W George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194768242 PECOS PAC ID: 8325064967 Enrollment ID: I20051021000785 |
| Provider Name | Abby D Mcneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487672283 PECOS PAC ID: 5991709982 Enrollment ID: I20060906000071 |
| Provider Name | Gary D Carr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093887945 PECOS PAC ID: 7113987470 Enrollment ID: I20070518000526 |
| Provider Name | Venkatasubramanian Baskararajan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407052228 PECOS PAC ID: 5496800229 Enrollment ID: I20090831000674 |
| Provider Name | Roderick T Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235472697 PECOS PAC ID: 7810115029 Enrollment ID: I20140902000316 |
| Provider Name | Holly M Kinget |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336376953 PECOS PAC ID: 6901026889 Enrollment ID: I20140926001175 |
| Provider Name | Shelley Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144452822 PECOS PAC ID: 9931329406 Enrollment ID: I20141003002096 |
| Provider Name | Karen Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386930477 PECOS PAC ID: 9931423431 Enrollment ID: I20150109000963 |
| Provider Name | Amy W Easley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720485600 PECOS PAC ID: 6709106479 Enrollment ID: I20150520000920 |
| Provider Name | Suzanne Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457504730 PECOS PAC ID: 6305152026 Enrollment ID: I20150826000981 |
| Provider Name | Melanie Monk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215254198 PECOS PAC ID: 3678854593 Enrollment ID: I20170106001203 |
| Provider Name | Kelechi Nnamdi Emereonye |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023363173 PECOS PAC ID: 6204149057 Enrollment ID: I20170825000559 |
| Provider Name | Donald Allan Dearman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679084024 PECOS PAC ID: 9830457597 Enrollment ID: I20171229001789 |
| Provider Name | Kelly L Tinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407336423 PECOS PAC ID: 5294089900 Enrollment ID: I20181115002895 |
| Provider Name | Tiffany M Reffit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063033108 PECOS PAC ID: 3173954443 Enrollment ID: I20200521000467 |
| Provider Name | Laterra Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417608985 PECOS PAC ID: 6406240308 Enrollment ID: I20220217002879 |
| Provider Name | Hena Arora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821742289 PECOS PAC ID: 4880073501 Enrollment ID: I20220626000018 |
| Provider Name | Nancy Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770161978 PECOS PAC ID: 9739552746 Enrollment ID: I20230222000634 |
| Provider Name | Tony E Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275854234 PECOS PAC ID: 2365797826 Enrollment ID: I20230306002244 |
| Provider Name | Amanda Michelle Whitacre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215309133 PECOS PAC ID: 5597130393 Enrollment ID: I20230410001308 |
| Provider Name | Jerry R Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679292916 PECOS PAC ID: 2668847385 Enrollment ID: I20230412000346 |
| Provider Name | Sharon Suzanne Nightengale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538872379 PECOS PAC ID: 4789043183 Enrollment ID: I20230703001668 |
| Provider Name | Cassey M Cuevas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659061646 PECOS PAC ID: 3173982071 Enrollment ID: I20230711001171 |
| Provider Name | Tina Denise Mcdyess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689393407 PECOS PAC ID: 0143684894 Enrollment ID: I20230913002248 |
| Provider Name | Kevin Ho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811587116 PECOS PAC ID: 4284089608 Enrollment ID: I20231004003095 |
| Provider Name | Elizabeth Garriga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962165852 PECOS PAC ID: 3072969765 Enrollment ID: I20231101002375 |
| Provider Name | Valerie Aikens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346838588 PECOS PAC ID: 6901256684 Enrollment ID: I20231220003466 |
| Provider Name | Byron Dukes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053834002 PECOS PAC ID: 1951751684 Enrollment ID: I20231221001092 |
| Provider Name | Melody Landrum Arnold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710571963 PECOS PAC ID: 6103276712 Enrollment ID: I20231222000650 |
| Provider Name | Jessica Mclain |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1063089530 PECOS PAC ID: 8729430319 Enrollment ID: I20240118004723 |
| Provider Name | Christine Annette Smothers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790799138 PECOS PAC ID: 6305299272 Enrollment ID: I20240126001729 |
| Provider Name | Kathleen Cox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407310709 PECOS PAC ID: 8224472212 Enrollment ID: I20240218000048 |
| Provider Name | Garland W King |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750513511 PECOS PAC ID: 9830534825 Enrollment ID: I20240229001882 |
| Provider Name | Lakeshia Fisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861968182 PECOS PAC ID: 5597103127 Enrollment ID: I20240402002376 |
| Provider Name | Ashley Nicole Chism |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255181095 PECOS PAC ID: 3476096736 Enrollment ID: I20240614003913 |
| Provider Name | Barry Pickreign |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871211854 PECOS PAC ID: 2769925841 Enrollment ID: I20240617004041 |
| Provider Name | Latonya Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659135440 PECOS PAC ID: 3779029210 Enrollment ID: I20240722000374 |
The Hope Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-264-0890 Fax: 601-261-0471 | |
Adcock Behavioral Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Donwood Pl, Hattiesburg, MS 39401 Phone: 601-433-7950 | |
Ann-opal Counseling & Consulting, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1507 Hardy St, Suite 104, Hattiesburg, MS 39401 Phone: 601-336-6847 Fax: 601-510-9403 | |
Magnolia Behavioral Psychology, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6668 Hwy 98, Suite A, Hattiesburg, MS 39402 Phone: 601-348-7792 | |
Wesley Health System Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5001 Hardy St, Hattiesburg, MS 39402 Phone: 601-268-8000 Fax: 601-268-5008 | |
Will's Way, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 Adeline St, Suite B, Hattiesburg, MS 39401 Phone: 601-466-9190 Fax: 186-662-5055 | |
Anchored Hope Clinic, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 423 Weathersby Rd Ste 180, Hattiesburg, MS 39402 Phone: 601-376-9144 Fax: 601-429-9300 |