| Sound Mind Psychiatry Pllc | |
|
105 W Hamilton St Houston MS 38851-2209 | |
| (662) 305-5998 | |
| Not Available |
| Full Name | Sound Mind Psychiatry Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 105 W Hamilton St, Houston, Mississippi |
| Authorized Official Name and Position | Colby Ponder (OWNER) |
| Authorized Official Contact | 6623055998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sound Mind Psychiatry Pllc 105 W Hamilton St Houston MS 38851-2209 Ph: (662) 305-5998 | Sound Mind Psychiatry Pllc 105 W Hamilton St Houston MS 38851-2209 Ph: (662) 305-5998 |
| NPI Number | 1174157689 |
|---|---|
| Provider Enumeration Date | 02/24/2020 |
| Last Update Date | 06/01/2020 |
| Certification Date | 06/01/2020 |
| Medicare PECOS PAC ID | 2264856673 |
|---|---|
| Medicare Enrollment ID | O20200717002584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174157689 | NPI | - | NPPES |
| Provider Name | Whitney Nicole Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457834913 PECOS PAC ID: 5597004598 Enrollment ID: I20190311000509 |
| Provider Name | Colby Blake Ponder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023572294 PECOS PAC ID: 8426390824 Enrollment ID: I20190506001159 |
| Provider Name | Jessica Hutchison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114653433 PECOS PAC ID: 6204211873 Enrollment ID: I20220917000631 |
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