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Organization
PURE LIGHT PSYCHIATRY LLC
Active
Organization
PURE LIGHT PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE MACHELLE DOUGLASS APRN, PMHNP (PMHNP)
(662) 890-7010
Entity
Organization
Contact information
Practice address
5600 GOODMAN RD STE B, OLIVE BRANCH, MS 38654-7002
(662) 890-7010
(662) 890-7044
Mailing address
5600 GOODMAN RD STE B, OLIVE BRANCH, MS 38654-7002
(662) 890-7010
(662) 890-7044
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
06/23/2025
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