Healthcare Provider Details

I. General information

NPI: 1295952992
Provider Name (Legal Business Name): NURSING HOME PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 08/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ARCHIE WHEAT RD
POPLARVILLE MS
39470-5515
US

IV. Provider business mailing address

85 WHISPERWOOD BLVD STE 2R
SLIDELL LA
70458-1136
US

V. Phone/Fax

Practice location:
  • Phone: 985-781-8565
  • Fax:
Mailing address:
  • Phone: 985-781-8565
  • Fax: 985-781-5395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: RODNEY D HESSON
Title or Position: PRESIDENT
Credential: PSYD
Phone: 601-749-9477