# INNOVATIVE BEHAVIORALS SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** IBS, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578578092
- **Authorized official:** DR. DOROTHY J MCGILL PHD (COO)
- **Authorized official phone:** (601) 952-0894

## Contact information

- **Practice address:** 357 TOWNE CENTER BLVD, SUITE \# 100, RIDGELAND, MS 39157-4837
- **Practice address phone:** (601) 952-0894
- **Practice address fax:** (601) 952-0836
- **Mailing address:** 357 TOWNE CENTER BLVD, SUITE \# 100, RIDGELAND, MS 39157-4837
- **Mailing address phone:** (601) 952-0894
- **Mailing address fax:** (601) 952-0836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LH0186 | MS | — |
| 103TC0700X | Clinical Psychologist | 34561 | MS | — |
| 1041C0700X | Clinical Social Worker | C6034 | MS | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 05/06/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09015770 | — | MS |
| 01 | — | 587443922 | BLUE CROSS BLUE SHIELD | MS |