MEDICARE: TURNED LEAF PSYCHIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1437043403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TURNED LEAF PSYCHIATRY LLC

Provider Business Mailing Address
First Line	:	745 AVIGNON DR STE C
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-5186
Country	:	US
Telephone Number	:	601-540-3520
Fax Number	:	601-429-9334

Provider Business Practice Location Address
First Line	:	745 AVIGNON DR STE C
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-5186
Country	:	US
Telephone Number	:	601-540-3520
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHEN SWEENEY
Credential	:
Telephone Number	:	601-540-3520

Provider Enumeration Date	:	06/04/2025
Last Update Date	:	02/10/2026

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