Destination Life Llc-s - Mental Health Clinic in Ellisville, MS

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Destination Life Llc-s is a mental health clinic (Clinical Nurse Specialist - Psychiatric/mental Health, Child & Adolescent) in Ellisville, Mississippi. The current practice location for Destination Life Llc-s is 7 Jonathan Way, Ellisville, Mississippi. For appointments, you can reach them via phone at (817) 473-1312. The mailing address for Destination Life Llc-s is 2001 Se Green Oak Blvd Ste 130, Arlington, Texas and phone number is (817) 473-1312.

Destination Life Llc-s is licensed to practice in * (Not Available) (license number ) and its NPI number is 1023625894. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (817) 473-1312.

Contact Information

Destination Life Llc-s
7 Jonathan Way
Ellisville
MS 39437-5195
(817) 473-1312
(866) 990-2813

Map and Direction


Mental Health Clinic Profile

Full NameDestination Life Llc-s
SpecialityClinical Nurse Specialist - Psychiatric/mental Health, Child & Adolescent
Location7 Jonathan Way, Ellisville, Mississippi
Authorized Official Name and PositionZemelda D. Carr (ADM)
Authorized Official Contact8174731312
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Destination Life Llc-s
2001 Se Green Oak Blvd Ste 130
Arlington
TX 76018-0952

Ph: (817) 473-1312		Destination Life Llc-s
7 Jonathan Way
Ellisville
MS 39437-5195

Ph: (817) 473-1312

NPI Details:

NPI Number1023625894
Provider Enumeration Date09/25/2020
Last Update Date07/30/2021
Certification Date07/30/2021

Medical Identifiers

Medical identifiers for Destination Life Llc-s such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023625894NPI-NPPES
03320311MedicaidMS
25D2200016OtherMSCLIA
1C5803OtherTXGROUP

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical (* (Not Available))Secondary
163WP0807XRegistered Nurse - Psychiatric/mental Health, Child & Adolescent (* (Not Available))Secondary
225X00000XOccupational Therapist (* (Not Available))Secondary
225XM0800XOccupational Therapist - Mental Health (* (Not Available))Secondary
261QP2300XClinic/center - Primary Care (* (Not Available))Secondary
261QR0401XClinic/center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (corf) (* (Not Available))Secondary
291U00000XClinical Medical Laboratory (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary
363LC1500XNurse Practitioner - Community Health (* (Not Available))Secondary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health (* (Not Available))Secondary
363LW0102XNurse Practitioner - Women's Health (* (Not Available))Secondary
364S00000XClinical Nurse Specialist (* (Not Available))Secondary
364SP0808XClinical Nurse Specialist - Psychiatric/mental Health (* (Not Available))Secondary
364SP0807XClinical Nurse Specialist - Psychiatric/mental Health, Child & Adolescent (* (Not Available))Primary

Reviews and Comments

Clinical Nurse Specialist in Ellisville, MS

Promises Counseling
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 812 Highway 11 S, Ellisville, MS 39437
Phone: 601-643-9815    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.