Healthcare Provider Details
I. General information
NPI: 1881560431
Provider Name (Legal Business Name): SOUTH MISSISSIPPI BEHAVIORAL MEDICINE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10189 LAKE FOREST DR
OCEAN SPRINGS MS
39565-2010
US
IV. Provider business mailing address
10189 LAKE FOREST DR
OCEAN SPRINGS MS
39565-2010
US
V. Phone/Fax
- Phone: 228-238-4095
- Fax:
- Phone: 228-238-4095
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RONALD
WAYNE
ALEXANDER
JR.
Title or Position: PSYCHOLOGIST/OWNER
Credential: PHD, DBSM
Phone: 228-238-4095