Healthcare Provider Details

I. General information

NPI: 1821308214
Provider Name (Legal Business Name): JONATHAN HUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3304 N STATE ST STE 201C
JACKSON MS
39216-3129
US

IV. Provider business mailing address

299 WOOD DALE DR
JACKSON MS
39216-3510
US

V. Phone/Fax

Practice location:
  • Phone: 601-942-3102
  • Fax: 855-795-3424
Mailing address:
  • Phone: 601-942-3102
  • Fax: 855-795-3424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2163
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2163
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: