Healthcare Provider Details

I. General information

NPI: 1467239772
Provider Name (Legal Business Name): OCEAN SPRINGS PSYCHIATRIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 BIENVILLE BLVD STE 2
OCEAN SPRINGS MS
39564-3130
US

IV. Provider business mailing address

57 HIGHLANDER
HATTIESBURG MS
39402-7779
US

V. Phone/Fax

Practice location:
  • Phone: 601-909-9394
  • Fax:
Mailing address:
  • Phone: 601-329-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NEELOU PATEL
Title or Position: NURSE PRACTITIONER
Credential: PMHNP
Phone: 601-329-1268