Provider Demographics
NPI:1174497994
Name:MENTAL HEALTH ASSC OF MS
Entity type:Organization
Organization Name:MENTAL HEALTH ASSC OF MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:601-850-1087
Mailing Address - Street 1:1501 JACKSONIAN PLZ STE 14131
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5454
Mailing Address - Country:US
Mailing Address - Phone:769-300-5340
Mailing Address - Fax:
Practice Address - Street 1:1501 JACKSONIAN PLZ STE 14131
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5454
Practice Address - Country:US
Practice Address - Phone:769-300-5340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-03
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health