WELLNESS CLINIC, P.C.
NPI 1386860898
Psychologist - Prescribing (Medical) in Southaven, MS
- Organization
- Psychologist
- Prescribing (Medical)
About WELLNESS CLINIC, P.C.
This page provides the complete NPI Profile along with additional information for Wellness Clinic, P.c., a provider established in Southaven, Mississippi operating as a Psychologist, focusing in prescribing (medical) . The healthcare provider is registered in the NPI registry with number 1386860898 assigned on April 2007. The practitioner's primary taxonomy code is 103TP0016X with license number MD000025744 (TN). The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Savira V Sidhu M.d. (President)
- NPI
- 1386860898 Verify this NPI
- Provider Name
- WELLNESS CLINIC, P.C.
- Entity Type
- Organization
- Location Address
- 5740 GETWELL RD BLDG 4C SOUTHAVEN, MS 38672
- Location Phone
- (662) 892-5000
- Location Fax
- (662) 892-5002
- Mailing Address
- PO BOX 2024 OLIVE BRANCH, MS 38654
- Mailing Phone
- (662) 892-5000
- Mailing Fax
- (662) 892-5002
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-17-2007
- Last Update Date
- 02-15-2011
- 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
Psychologist Prescribing (Medical)
- Taxonomy Code
- 103TP0016X
- Type
- Behavioral Health & Social Service Providers
- License No.
- MD000025744
- License State
- TN
- Taxonomy Description
- A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| F95674 | MEDICARE UPIN (02) | ||
| C04533 | MEDICARE UPIN (02) | MS | |
| F95674 | MEDICAID (05) | MS | |
| 260000711 | MEDICARE ID-TYPE UNSPECIFIED (04) | MS | |
| 3725205 | MEDICAID (05) | TN | |
| 3725205 | MEDICARE ID-TYPE UNSPECIFIED (04) | TN | |
| 00120361 | MEDICAID (05) | MS |
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Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
SOUTHAVEN, MS 38672
SOUTHAVEN, MS 38672
SOUTHAVEN, MS 38672
SOUTHAVEN, MS 38672
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386860898, enumerated as an "organization" on April 17, 2007.
The provider is located at 5740 GETWELL RD BLDG 4C SOUTHAVEN, MS 38672 and the phone number is (662) 892-5000.
Psychologist with taxonomy code 103TP0016X and a focus in Prescribing (Medical).
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
