Provider Demographics
NPI:1518411529
Name:CHILDREN'S PSYCHIATRIC SOLUTIONS
Entity Type:Organization
Organization Name:CHILDREN'S PSYCHIATRIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:DE'SHA
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-939-7990
Mailing Address - Street 1:3531 LAKELAND DR
Mailing Address - Street 2:STE 1052
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-8049
Mailing Address - Country:US
Mailing Address - Phone:601-939-7990
Mailing Address - Fax:601-939-7254
Practice Address - Street 1:3531 LAKELAND DR
Practice Address - Street 2:STE 1052
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8049
Practice Address - Country:US
Practice Address - Phone:601-939-7990
Practice Address - Fax:601-939-7254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901668363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty