Healthcare Provider Details

I. General information

NPI: 1700797024
Provider Name (Legal Business Name): JAMIE METHVIN P-LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STARR AVE STE K
STARKVILLE MS
39759-4032
US

IV. Provider business mailing address

210 LOUISVILLE ST APT M
STARKVILLE MS
39759-3238
US

V. Phone/Fax

Practice location:
  • Phone: 662-338-6545
  • Fax:
Mailing address:
  • Phone: 662-338-6545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP-1433
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: