Individual
PHILIP MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5345 HIGHWAY 18 W, JACKSON, MS 39209-9421
(601) 927-0188
(601) 292-7998
Mailing address
PO BOX 2305, CLINTON, MS 39060-2305
(601) 272-2202
(601) 292-7998
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
AD07-046M
MS
104100000X
Social Worker
M7217
MS
1041C0700X
Clinical Social Worker
Primary
C7217
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05671221
—
MS
Enumeration date
11/17/2014
Last updated
09/11/2023
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