1376669135 NPI number — REGION VII MH MR COMMISSION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376669135 NPI number — REGION VII MH MR COMMISSION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGION VII MH MR COMMISSION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY COUNSELING SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376669135
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
302 N JACKSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STARKVILLE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39759-2504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-323-9261
Provider Business Mailing Address Fax Number:
662-324-9647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39701-4751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-328-9225
Provider Business Practice Location Address Fax Number:
662-328-4735
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DOSS
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ACCTS REC SUPERVISOR
Authorized Official Telephone Number:
662-323-9261

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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