Provider Demographics
NPI:1295474617
Name:DEEP CONNECTIONS MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:DEEP CONNECTIONS MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCH NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GATHINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-244-9633
Mailing Address - Street 1:221 7TH ST N STE 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-4549
Mailing Address - Country:US
Mailing Address - Phone:662-244-9633
Mailing Address - Fax:
Practice Address - Street 1:221 7TH ST N STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-4549
Practice Address - Country:US
Practice Address - Phone:662-244-9633
Practice Address - Fax:601-258-9573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty