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PRIMARY AND BEHAVIORAL HEALTHCARE SERVICES, PA
NPI 1679135982
Counselor - Mental Health in Jackson, MS

Active since July 08, 2019CLIA 25D2168476 · Waiver
717 E FORTIFICATION ST, JACKSON, MS 39202(769) 572-4009(769) 572-4021 Get Directions Write a Review

NPPES record last updated: October 28, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 28, 2019, Oct 23, 2019, Oct 14, 2019 and 1 more (4 updates tracked since 2019).

About Primary And Behavioral Healthcare Services, Pa NPPES

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

PRIMARY AND BEHAVIORAL HEALTHCARE SERVICES, PA (NPI 1679135982) is a healthcare organization registered as a mental health in Jackson, Mississippi and active in the NPI registry since July 2019. The organization holds a CLIA Waiver certificate valid through June 30, 2027 and lists Shameca Leonora Hudson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1679135982
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NamePRIMARY AND BEHAVIORAL HEALTHCARE SERVICES, PA
Location Address717 E FORTIFICATION STJackson, MS 39202-2402
Mailing Address717 E Fortification StJackson, MS 39202-2402 · (769) 572-4009 · Fax (769) 572-4021
Phone(769) 572-4009
Fax(769) 572-4021
Organization SubpartNo
Authorized OfficialShameca Leonora HudsonCeo · (769) 572-4009
Enumeration DateJuly 8, 2019
Last NPPES UpdateOctober 28, 20194 updates tracked since enumeration
✔ NPI 1679135982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
717 E FORTIFICATION ST, Jackson, MS 39202
Open in Google Maps ↗

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

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 25D2168476

Primary And Behavioral Healthcare Services · Jackson, MS
Active · expires Jun 30, 2027
CLIA Number25D2168476
Laboratory TypePractitioner Other
Certificate Effective DateJuly 1, 2025
Certificate Expiration DateJune 30, 2027
Laboratory DirectorShameca L. Hudson
Laboratory Phone(769) 572-4009
Laboratory LocationPrimary And Behavioral Healthcare Services717 East Fortification Street, Jackson, MS 39202
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

SHAMECA HUDSON DNP, FNP-BC,PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
717 E FORTIFICATION ST
JACKSON, MS 39202
Hinds County (769) 572-4009

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 Primary And Behavioral Healthcare Services, PA's NPI number?

The NPI number for Primary And Behavioral Healthcare Services, PA is 1679135982. It was assigned to this organization in the NPPES registry on July 8, 2019.

Where is Primary And Behavioral Healthcare Services, PA located?

Primary And Behavioral Healthcare Services, PA is located at 717 E Fortification St, Jackson, MS 39202. The listed phone number is (769) 572-4009.

What is Primary And Behavioral Healthcare Services, PA's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Does Primary And Behavioral Healthcare Services, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2168476) is associated with this NPI, valid through June 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Primary And Behavioral Healthcare Services, PA accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee list Primary And Behavioral Healthcare Services, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Primary And Behavioral Healthcare Services, PA was last updated on October 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.