| Positive Pathways, LLC | |
|
1905 Mission 66 Vicksburg MS 39180-3711 | |
| (601) 813-5878 | |
| Not Available |
| Full Name | Positive Pathways, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1905 Mission 66, Vicksburg, Mississippi |
| Authorized Official Name and Position | Timeka Sheree Wright (PRESIDENT) |
| Authorized Official Contact | 6018135878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Pathways, LLC 1905 Mission 66 Vicksburg MS 39180-3711 Ph: (601) 813-5878 | Positive Pathways, LLC 1905 Mission 66 Vicksburg MS 39180-3711 Ph: (601) 813-5878 |
| NPI Number | 1801335492 |
|---|---|
| Provider Enumeration Date | 02/16/2017 |
| Last Update Date | 03/19/2025 |
| Certification Date | 03/19/2025 |
| Medicare PECOS PAC ID | 0648678425 |
|---|---|
| Medicare Enrollment ID | O20211021000305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801335492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
| Provider Name | Donna Kay Pittman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205915428 PECOS PAC ID: 3072641430 Enrollment ID: I20100506000170 |
| Provider Name | Maurice Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558393843 PECOS PAC ID: 7517126360 Enrollment ID: I20120314000215 |
| Provider Name | Cassandra Kingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144714353 PECOS PAC ID: 2567799679 Enrollment ID: I20190813001362 |
| Provider Name | Joycelyn Lashae Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649879461 PECOS PAC ID: 7517355530 Enrollment ID: I20211025002250 |
| Provider Name | Amanda Brooke Roach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366918195 PECOS PAC ID: 5991193468 Enrollment ID: I20211102003425 |
| Provider Name | Marie Ross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750737839 PECOS PAC ID: 2769822535 Enrollment ID: I20240426000447 |
| Provider Name | Courtney Perry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326713777 PECOS PAC ID: 2163955642 Enrollment ID: I20241023002399 |
| Provider Name | Laura Russell Pitre |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477259554 PECOS PAC ID: 4284167552 Enrollment ID: I20241024002473 |
| Provider Name | Doug Fitzgerald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417130600 PECOS PAC ID: 8527591817 Enrollment ID: I20241024003158 |
| Provider Name | Makeshia Warden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013478643 PECOS PAC ID: 4688107980 Enrollment ID: I20241024003868 |
| Provider Name | Sheila Runnels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184390841 PECOS PAC ID: 2860925807 Enrollment ID: I20241029001909 |
| Provider Name | Cleopatra Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487490629 PECOS PAC ID: 4284157579 Enrollment ID: I20250327001147 |
| Provider Name | Juliet Warriner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588496962 PECOS PAC ID: 4183122518 Enrollment ID: I20250813003451 |
| Provider Name | Aleicha Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588939078 PECOS PAC ID: 7214424134 Enrollment ID: I20251014003942 |
Warren Yazoo Mental Health Service Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-634-0234 |
Vicksburg Center for Exceptional Children Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Herrod St, Vicksburg, MS 39180 Phone: 601-218-5497 |
The Peace Place Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 Holly St, Vicksburg, MS 39180 Phone: 601-630-3362 Fax: 855-540-0718 |
Divine Home Care Changes Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Ethel Dr, Vicksburg, MS 39180 Phone: 919-339-1854 |
Nulife Healthcare, LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Holt Collier Dr Ste C, Vicksburg, MS 39183 Phone: 601-738-5565 Fax: 601-738-5544 |
Cognitive Development Center of Mississippi Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1713 Clay St, Vicksburg, MS 39183 Phone: 601-883-1771 Fax: 601-883-1773 |