1. Home
  2. Directory
  3. Mississippi
  4. Jackson
  5. Counselor
  6. NPI Profile

DEIDERE HOLLINS LPC-S
NPI 1336521970
Counselor - Professional in Jackson, MS

Active since June 19, 2015PECOS EnrolledAccepts Medicare Assignment
3450 HIGHWAY 80 W, JACKSON, MS 39209(601) 321-2400(601) 985-5174 Get Directions Write a Review

NPPES record last updated: July 11, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Deidere Hollins Lpc-s NPPES

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

DEIDERE HOLLINS LPC-S (NPI 1336521970) is an individual professional provider in Jackson, Mississippi, licensed in Mississippi (1628) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1336521970
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameDEIDERE HOLLINSCredential: LPC-S
Location Address3450 HIGHWAY 80 WJackson, MS 39209-7201
Mailing Address109 Magnolia WayPearl, MS 39208-3366 · (601) 573-9849
Phone(601) 321-2400
Fax(601) 985-5174
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateJune 19, 2015
Last NPPES UpdateJuly 11, 2018
✔ NPI 1336521970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MS · 1628
3450 HIGHWAY 80 W, Jackson, MS 39209
Open in Google Maps ↗

Other Identifiers 1

Medicaid00018209MS

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Deidere Hollins Lpc-s is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799260634
PECOS Enrollment IDI20260330001460
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

ELLEEANNA LAWSON CAT,LMSW
Counselor (Addiction (Substance Use Disorder))
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (601) 321-2497
MEGAN M MCCARTY LMSW
Social Worker
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (601) 321-2400
ANGELA NICOLE CHILDRESS LMSW
Social Worker
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (601) 321-2400
MRS. EBONY HUMPHERY PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (601) 321-2400
ANDRIA WILLIS BSW
Case Manager/Care Coordinator
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (769) 257-4562
BRENDA WALKER
Counselor (Addiction (Substance Use Disorder))
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (601) 321-2497
EVE WILLIAMS
Counselor (Mental Health)
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (601) 321-2400
MS. ANGELICA GOWDY PCMHT
Counselor (Mental Health)
3450 HIGHWAY 80 W
JACKSON, MS 39209
Hinds County (601) 321-2400

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 Deidere Hollins's NPI number?

The NPI number for Deidere Hollins is 1336521970. It was assigned to this individual provider in the NPPES registry on June 19, 2015.

Where is Deidere Hollins located?

Deidere Hollins practices at 3450 Highway 80 W, Jackson, MS 39209. The listed phone number is (601) 321-2400.

What is Deidere Hollins's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Deidere Hollins enrolled in Medicare?

Yes. Deidere Hollins is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Deidere Hollins was last updated on July 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.