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PSYCHOSOCIAL BOUTIQUE, PLLC.
NPI 1841846904
Clinic/Center - Mental Health (Including Community Mental Health Center) in Horn Lake, MS

Active since August 14, 2019
1751 DANCY BLVD, HORN LAKE, MS 38637(662) 892-2660 Get Directions Write a Review

NPPES record last updated: November 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 29, 2025, Jun 26, 2025, Feb 22, 2023 and 5 more (8 updates tracked since 2019).

About Psychosocial Boutique, Pllc. NPPES

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

PSYCHOSOCIAL BOUTIQUE, PLLC. (NPI 1841846904) is a healthcare organization registered as a mental health (including community mental health center) in Horn Lake, Mississippi and active in the NPI registry since August 2019. The organization maintains 2 additional practice locations and lists Syrenia Johnson, Owner/practitioner, as its authorized official.

NPPES Registry Identity

NPI1841846904
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NamePSYCHOSOCIAL BOUTIQUE, PLLC.
Location Address1751 DANCY BLVDHorn Lake, MS 38637-1916
Mailing Address1350 Sunset Dr Ste DGrenada, MS 38901-4079 · (662) 892-2660
Phone(662) 892-2660
Organization SubpartNo
Authorized OfficialSyrenia JohnsonOwner/practitioner · (662) 892-2660
Enumeration DateAugust 14, 2019
Last NPPES UpdateNovember 29, 20258 updates tracked since enumeration
NPPES CertifiedNovember 29, 2025
✔ NPI 1841846904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
1751 DANCY BLVD, Horn Lake, MS 38637
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Secondary Practice Locations 2

Location 11350 Sunset Dr Ste DGrenada, MS 38901-4079 · Phone (662) 892-2660
Location 2144 S Thomas St Ste 211Tupelo, MS 38801-5331 · Phone (662) 892-2660

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Psychosocial Boutique, Pllc. 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 Psychosocial Boutique, PLLC., which bills Medicare for the services this clinician delivers.

Clinician (1)

Syrenia Johnson, LCSW
Clinical Social Worker
NPI 1598113482
1751 DANCY BLVD
Horn Lake, MS 38637
(662) 892-2660
✔ PECOS✔ Accepts MedicareSame 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 Psychosocial Boutique, PLLC.'s NPI number?

The NPI number for Psychosocial Boutique, PLLC. is 1841846904. It was assigned to this organization in the NPPES registry on August 14, 2019.

Where is Psychosocial Boutique, PLLC. located?

Psychosocial Boutique, PLLC. is located at 1751 Dancy Blvd, Horn Lake, MS 38637. The listed phone number is (662) 892-2660.

What is Psychosocial Boutique, PLLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Psychosocial Boutique, PLLC. enrolled in Medicare?

Yes. Psychosocial Boutique, PLLC. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Psychosocial Boutique, PLLC.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Psychosocial Boutique, PLLC.. 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 Psychosocial Boutique, PLLC. was last updated on November 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.