Provider Demographics
NPI:1669513503
Name:CATHOLIC CHARITIES, INC.
Entity type:Organization
Organization Name:CATHOLIC CHARITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:601-326-3728
Mailing Address - Street 1:200 N CONGRESS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39201-1902
Mailing Address - Country:US
Mailing Address - Phone:601-326-3701
Mailing Address - Fax:601-960-8493
Practice Address - Street 1:200 N CONGRESS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39201-1902
Practice Address - Country:US
Practice Address - Phone:601-326-3701
Practice Address - Fax:601-960-8493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSCYS23CRT01251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00016925Medicaid