PEDIATRIC HAVEN AUTISM CENTER
NPI 1043858053
Clinic/Center - Adolescent and Children Mental Health in Madison, MS
NPI Status: Active since December 20, 2019
Contact Information
102 LEXINGTON DR
MADISON, MS
ZIP 39110
Phone: (601) 499-6696
Fax: (601) 499-6696
- Organization
- Clinic/Center
- Adolescent and Children Mental Health
- Accepts Insurance
About PEDIATRIC HAVEN AUTISM CENTER
This page provides the complete NPI Profile along with additional information for Pediatric Haven Autism Center, a provider established in Madison, Mississippi operating as a Clinic/center, focusing in adolescent and children mental health . The healthcare provider is registered in the NPI registry with number 1043858053 assigned on December 2019. The practitioner's primary taxonomy code is 261QM0855X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Pediatric Haven Autism Center. The authorized official of this NPI record is Mrs. Jetuwan M. Brown Rn (Managing Partner)
- NPI
- 1043858053
- Provider Legal Name
- PEDIATRIC HAVEN
- Other Organization Name
- PEDIATRIC HAVEN AUTISM CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 102 LEXINGTON DR MADISON, MS 39110
- Location Phone
- (601) 499-6696
- Location Fax
- (601) 499-6696
- Mailing Address
- 103 HONOURS DR MADISON, MS 39110
- Mailing Phone
- (601) 622-2997
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-20-2019
- Last Update Date
- 01-04-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Adolescent and Children Mental Health
- Taxonomy Code
- 261QM0855X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
| 2 | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | |
| 3 | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | |
| 4 | 261QM3000X | Ambulatory Health Care Facilities | Clinic/Center | |
| 5 | 3140N1450X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | |
| 6 | 385HR2055X | Respite Care Facility | Respite Care | |
| 7 | 385HR2060X | Respite Care Facility | Respite Care | |
| 8 | 385HR2065X | Respite Care Facility | Respite Care |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoice) + Vision + Adult Dental - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Molina Gold Standard - HMO
- Molina Silver Standard - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple Chronic Care CKM - HMO
- Gold Classic Standard - HMO
- Silver Classic Standard - HMO
- Silver Simple - HMO
- Silver Simple Chronic Care CKM - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1043858053, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043858053, enumerated as an "organization" on December 20, 2019.
The provider is located at 102 LEXINGTON DR MADISON, MS 39110 and the phone number is (601) 499-6696.
Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.
