BEACON BEHAVIORAL HEALTH-JACKSON
NPI 1194964049
Clinic/Center - Mental Health (Including Community Mental Health Center) in Jackson, MS

NPI Status: Active since February 17, 2009

Contact Information

5360 I 55 N
JACKSON, MS
ZIP 39211
Phone: (601) 373-4507

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  • Organization
  • Clinic/Center
  • Mental Health (Including Community Menta...
  • CLIA Number: 19D2027835
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 08-01-2027

About BEACON BEHAVIORAL HEALTH-JACKSON

This page provides the complete NPI Profile along with additional information for Beacon Behavioral Health-jackson, a provider established in Jackson, Mississippi operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1194964049 assigned on February 2009. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Mr. Phillip Wendell (Ceo)

NPI
1194964049
Provider Name
BEACON BEHAVIORAL HEALTH-JACKSON
Entity Type
Organization
Location Address
5360 I 55 N JACKSON, MS 39211
Location Phone
(601) 373-4507
Mailing Address
9938 AIRLINE HIGHWAY SUITE 200 BATON ROUGE, LA 70816
Mailing Phone
(225) 810-4040
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-17-2009
Last Update Date
02-17-2009
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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 Mental Health (Including Community Mental Health Center)

Taxonomy Code
261QM0801X
Type
Ambulatory Health Care Facilities
License State
MS

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. PHILLIP WENDELL

Authorized Official Title
CEO
Authorized Official Phone
(225) 810-4040

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
19D2027835
Facility Type
Hospital
Certificate Effective Date
August 02, 2025
Certificate Expiration Date
August 01, 2027
Laboratory Director
DENISE WHITE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Beacon Behavioral Health-jackson to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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 1194964049, we treat the final digit (9) 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 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).

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.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
6
Unchanged
Pos 7
4
Doubled → 8
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
9
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 9 → 18 → 9 9 → 18 → 9 4 → 8 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 8 + 4 + 1 + 8 + 6 + 8 + 0 + 8 + 24 = 71

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 71 is 80. The difference is the calculated check digit.

80 - 71 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1194964049.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194964049, enumerated as an "organization" on February 17, 2009.

The provider is located at 5360 I 55 N JACKSON, MS 39211 and the phone number is (601) 373-4507.

Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).