Healthcare Provider Details

I. General information

NPI: 1992513733
Provider Name (Legal Business Name): HOPECREST MENTAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 FOURTH AVE
DECATUR MS
39327-9713
US

IV. Provider business mailing address

68 FOURTH AVE
DECATUR MS
39327-9713
US

V. Phone/Fax

Practice location:
  • Phone: 601-921-9708
  • Fax:
Mailing address:
  • Phone: 601-921-9708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARRI MYERS
Title or Position: OWNER
Credential: PMHNP
Phone: 601-921-9708