NPI Index

DESTINATION LIFE LLC-S

Clinical Nurse Specialist - Psychiatric/Mental Health, Child & Adolescent

Active Organization
NPI: 1023625894

Practice Address

7 JONATHAN WAY
Ellisville, MS 39437

Phone: (817) 473-1312

Specialties

Specialty Code Primary License
Social Worker - Clinical 1041C0700X No -
Registered Nurse - Psychiatric/Mental Health, Child & Adolescent 163WP0807X No -
Occupational Therapist 225X00000X No -
Occupational Therapist - Mental Health 225XM0800X No -
Clinic/Center - Primary Care 261QP2300X No -
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X No -
Clinical Medical Laboratory 291U00000X No -
Nurse Practitioner 363L00000X No -
Nurse Practitioner - Community Health 363LC1500X No -
Nurse Practitioner - Family 363LF0000X No -
Nurse Practitioner - Psychiatric/Mental Health 363LP0808X No -
Nurse Practitioner - Women's Health 363LW0102X No -
Clinical Nurse Specialist 364S00000X No -
Clinical Nurse Specialist - Psychiatric/Mental Health 364SP0808X No -
Clinical Nurse Specialist - Psychiatric/Mental Health, Child & Adolescent 364SP0807X Yes -

Frequently Asked Questions

NPI 1023625894 is the National Provider Identifier for DESTINATION LIFE LLC-S, a Clinical Nurse Specialist - Psychiatric/Mental Health, Child & Adolescent provider located in Ellisville, MS. This NPI was enumerated on September 25, 2020.

Quick Facts

NPI
1023625894
Type
Organization
Enumerated
Sep 25, 2020
Last Updated
Jul 30, 2021

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