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JACKSON COMPREHENSION TREATMENT CENTER
NPI 1003757675
Counselor - Addiction (Substance Use Disorder) in Jackson, MS

Active since April 06, 2026CLIA 25D2129737 · Waiver
1935 LAKELAND DR STE 900, JACKSON, MS 39216(601) 718-2468 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jackson Comprehension Treatment Center NPPES

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

JACKSON COMPREHENSION TREATMENT CENTER (NPI 1003757675) is a healthcare organization registered as an addiction (substance use disorder) in Jackson, Mississippi and active in the NPI registry since April 2026. The organization holds a CLIA Waiver certificate valid through April 24, 2027 and lists Derrick Dewayner Davis, 3c, as its authorized official.

NPPES Registry Identity

NPI1003757675
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NameJACKSON COMPREHENSION TREATMENT CENTER
Location Address1935 LAKELAND DR STE 900Jackson, MS 39216-5028
Mailing Address3333 W Northside Dr Lot 17Clinton, MS 39056-3353 · (601) 926-0569
Phone(601) 718-2468
Organization SubpartNo
Authorized OfficialDerrick Dewayner Davis3c · (601) 718-2468
Enumeration DateApril 6, 2026
NPPES CertifiedApril 6, 2026
✔ NPI 1003757675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
1935 LAKELAND DR STE 900, Jackson, MS 39216
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 25D2129737

Jackson Comprehensive Treatment Center · Jackson, MS
Active · expires Apr 24, 2027
CLIA Number25D2129737
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateApril 25, 2025
Certificate Expiration DateApril 24, 2027
Laboratory DirectorDr. William Johnson
Laboratory Phone(601) 718-2468
Laboratory LocationJackson Comprehensive Treatment Center1935 Lakeland Dr Ste 900, Jackson, MS 39216
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

MR. GEORGE WOODSON GULLY JR. LPN
Licensed Practical Nurse
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
MS. DETRA LA'QUEL HUMPHRIES RN
Registered Nurse (Addiction (Substance Use Disorder))
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2487
DENESHA SPENCER
Licensed Practical Nurse
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
JASMINE ROBB
Counselor (Addiction (Substance Use Disorder))
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 366-7167
DR. WILLIAM WALTER JOHNSON M.D.
Preventive Medicine (Addiction Medicine)
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 840-1454
SHANEIKA PARKER LPN
Licensed Practical Nurse
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
WILLIAM NATHAN CRAVEN
Clinic/Center (Methadone)
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2468
ROY CHESTER HARNESS MSW,PCHMT,PCAT
Counselor (Addiction (Substance Use Disorder))
1935 LAKELAND DR STE 900
JACKSON, MS 39216
Hinds County (601) 718-2648

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 Jackson Comprehension Treatment Center's NPI number?

The NPI number for Jackson Comprehension Treatment Center is 1003757675. It was assigned to this organization in the NPPES registry on April 6, 2026.

Where is Jackson Comprehension Treatment Center located?

Jackson Comprehension Treatment Center is located at 1935 Lakeland Dr Ste 900, Jackson, MS 39216. The listed phone number is (601) 718-2468.

What is Jackson Comprehension Treatment Center's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Does Jackson Comprehension Treatment Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2129737) is associated with this NPI, valid through April 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jackson Comprehension Treatment Center was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.