Healthcare Provider Details

I. General information

NPI: 1831022466
Provider Name (Legal Business Name): PEARL PSYCHIATRY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 S 16TH ST
OXFORD MS
38655-4409
US

IV. Provider business mailing address

PO BOX 165
OXFORD MS
38655-0165
US

V. Phone/Fax

Practice location:
  • Phone: 662-876-1549
  • Fax: 662-735-4500
Mailing address:
  • Phone: 662-876-1549
  • Fax: 662-735-4500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN BLACKBURN
Title or Position: OWNER/NP
Credential: PMHNP
Phone: 662-876-1549