Provider Demographics
NPI:1114662145
Name:HATTIESBURG PSYCHIATRIC SERVICES, LLC
Entity Type:Organization
Organization Name:HATTIESBURG PSYCHIATRIC SERVICES, LLC
Other - Org Name:LET'S TALK BEHAVIORAL HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:NEELOU
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:601-329-1268
Mailing Address - Street 1:34 MILLBRANCH RD STE 80
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1687
Mailing Address - Country:US
Mailing Address - Phone:601-909-9394
Mailing Address - Fax:601-909-9383
Practice Address - Street 1:34 MILLBRANCH RD STE 80
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1687
Practice Address - Country:US
Practice Address - Phone:601-909-9394
Practice Address - Fax:601-909-9383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty