St. Dominic Psychiatric Associates

LBN: St Dominic Medical Associates Llc
St. Dominic Psychiatric Associates is an health care organization with primary practice located at 969 Lakeland Dr St Thomas Hall, Jackson MS 39216-4606. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. St Dominic Medical Associates Llc can be contacted via phone (601) 200-3110, or through Stuart, Danielle via phone (601) 200-4880.

Contact Information

Primary practice address
969 Lakeland Dr St Thomas Hall Jackson MS 39216-4606
Phone: (601) 200-3110
Fax: (601) 200-3109
Website:
Map and Directions
Authorized official contact:
Name: Stuart, Danielle
Phone: (601) 200-4880

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1386708188
LBN Legal business name St Dominic Medical Associates Llc
DBA Doing business as St. Dominic Psychiatric Associates
Authorized official Stuart, Danielle
Entity Organization
Organization subpart 1 No
Enumeration date Dec 19th, 2006
Last updated Aug 11th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386708188 NPPES
Mississippi MEDICAID 00784213

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