LIVE OAK PSYCHOLOGICAL ASSOCITAES
NPI 1750577805
Psychologist - Clinical in Jackson, MS

Q: What is Live Oak Psychological Associtaes's NPI number?

The NPI number for Live Oak Psychological Associtaes is 1750577805. It was assigned to this organization in the NPPES registry on September 22, 2007.

Q: What is Live Oak Psychological Associtaes's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since September 22, 2007

1151 N STATE ST, STE 212, JACKSON, MS 39202(601) 352-7398(601) 352-0442 Get Directions Write a Review

NPPES record last updated: September 22, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Live Oak Psychological Associtaes NPPES

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

LIVE OAK PSYCHOLOGICAL ASSOCITAES (NPI 1750577805) is a healthcare organization registered as a clinical in Jackson, Mississippi and active in the NPI registry since September 2007. The organization lists Lisa Halderman Dieth, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1750577805

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameLIVE OAK PSYCHOLOGICAL ASSOCITAES

Location Address1151 N STATE ST, STE 212Jackson, MS 39202-2407

Mailing Address1151 N State St, Ste 212Jackson, MS 39202-2407 · (601) 352-7398 · Fax (601) 352-0442

Phone(601) 352-7398

Fax(601) 352-0442

Organization SubpartNo

Authorized OfficialLisa Halderman DiethOffice Manager · (601) 352-7398

Enumeration DateSeptember 22, 2007

✔ NPI 1750577805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1151 N STATE ST, Jackson, MS 39202

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Live Oak Psychological Associtaes is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Live Oak Psychological Associtaes, which bills Medicare for the services this clinician delivers.

Clinician (1)

James Brown, PSY.D.

Clinical Psychologist

NPI 1346374410

1151 N STATE ST STE 212
Jackson, MS 39202

(601) 352-7398

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Live Oak Psychological Associtaes's NPI number?

The NPI number for Live Oak Psychological Associtaes is 1750577805. It was assigned to this organization in the NPPES registry on September 22, 2007.

Where is Live Oak Psychological Associtaes located?

Live Oak Psychological Associtaes is located at 1151 N State St Ste 212, Jackson, MS 39202. The listed phone number is (601) 352-7398.

What is Live Oak Psychological Associtaes's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Live Oak Psychological Associtaes enrolled in Medicare?

Yes. Live Oak Psychological Associtaes is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Live Oak Psychological Associtaes?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Live Oak Psychological Associtaes. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Live Oak Psychological Associtaes was last updated on September 22, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.