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PSYCAMORE, LLC
NPI 1003195967
Clinic/Center - Adult Mental Health in Biloxi, MS

Active since August 10, 2011CLIA Certified · 3 labs
2620 EXECUTIVE PL, BILOXI, MS 39531(228) 385-7744(601) 939-5935 Get Directions Write a Review

NPPES record last updated: December 22, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 22, 2016, Nov 3, 2016 (2 updates tracked since 2016).

About Psycamore, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PSYCAMORE, LLC (NPI 1003195967) is a healthcare organization registered as an adult mental health in Biloxi, Mississippi and active in the NPI registry since August 2011. The organization holds 3 active CLIA laboratory certificates and lists Katherine A Hall, Director, Business Operations, as its authorized official.

NPPES Registry Identity

NPI1003195967
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NamePSYCAMORE, LLC
Location Address2620 EXECUTIVE PLBiloxi, MS 39531-3717
Mailing Address2620 Executive PlBiloxi, MS 39531-3717 · (601) 939-5993 · Fax (601) 939-5935
Phone(228) 385-7744
Fax(601) 939-5935
Organization SubpartNo
Authorized OfficialKatherine A HallDirector, Business Operations · (601) 939-5993
Enumeration DateAugust 10, 2011
Last NPPES UpdateDecember 22, 20162 updates tracked since enumeration
✔ NPI 1003195967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
License✔ Licensed in MS · DCS-PSYCAMORE-PHA-01
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X · License DCS-PSYCAMORE-PHA-01 (MS)
2620 EXECUTIVE PL, Biloxi, MS 39531
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2109400

Psycamore Psychiatric Program, LLC · Biloxi, MS
Active · expires Feb 23, 2028
CLIA Number25D2109400
Laboratory TypeBehavioral Hlt Php & Iop
Certificate Effective DateFebruary 24, 2026
Certificate Expiration DateFebruary 23, 2028
Laboratory DirectorSudhakar Madakasira
Laboratory Phone(601) 939-5993
Laboratory LocationPsycamore Psychiatric Program, LLC2620 Executive Place, Biloxi, MS 39531
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 25D1056894

Psycamore Psychiatric Program, LLC · Flowood, MS
Active · expires Feb 23, 2028
CLIA Number25D1056894
Laboratory TypeBehavioral Hlth Php & Iop
Certificate Effective DateFebruary 24, 2026
Certificate Expiration DateFebruary 23, 2028
Laboratory DirectorSudhakar Madakasira
Laboratory Phone(601) 939-5993
Laboratory LocationPsycamore Psychiatric Program, LLC2540 Flowood Drive, Flowood, MS 39232
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 25D2109398

Psycamore Psychiatric Program, LLC · Southaven, MS
Active · expires Feb 23, 2028
CLIA Number25D2109398
Laboratory TypeBehavioral Hlth Php & Iop
Certificate Effective DateFebruary 24, 2026
Certificate Expiration DateFebruary 23, 2028
Laboratory DirectorSudhakar Madakasira
Laboratory Phone(601) 939-5993
Laboratory LocationPsycamore Psychiatric Program, LLC7165 Getwell Road, Building G, Southaven, MS 38672
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAYLOR RITCHEY MS, LPC, NCC
Counselor (Professional)
2620 EXECUTIVE PL
BILOXI, MS 39531
Harrison County (228) 385-7744
MRS. MARY BERGENS DODSON LMFT
Marriage & Family Therapist
2620 EXECUTIVE PL
BILOXI, MS 39531
Harrison County (228) 385-7744
CATHERINE KOONTZ ROGERS MD
Psychiatry & Neurology (Psychiatry)
2620 EXECUTIVE PL
BILOXI, MS 39531
Harrison County (228) 385-7744
PASCAL DAVIS FRAISSE LCSW
Social Worker (Clinical)
2620 EXECUTIVE PL
BILOXI, MS 39531
Harrison County (228) 385-7744
MR. GABRIEL TAYLOR LPC
Counselor (Mental Health)
2620 EXECUTIVE PL
BILOXI, MS 39531
Harrison County (228) 385-7744

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Psycamore, LLC's NPI number?

The NPI number for Psycamore, LLC is 1003195967. It was assigned to this organization in the NPPES registry on August 10, 2011.

Where is Psycamore, LLC located?

Psycamore, LLC is located at 2620 Executive Pl, Biloxi, MS 39531. The listed phone number is (228) 385-7744.

What is Psycamore, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Does Psycamore, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Psycamore, LLC was last updated on December 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.