Organization
MISSISSIPPI STATE UNIVERSITY
Active
Parent organization
MISSISSIPPI STATE UNIVERSITY
Other names
MSU Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSISSIPPI STATE UNIVERSITY
Authorized official
DANIEL TODD HALE (DIRECTOR, FISCAL OPERATIONS, STUDEN)
(662) 325-5895
Entity
Organization
Contact information
Practice address
223 FAMOUS MAROON BAND STREET, MISSISSIPPI STATE, MS 39762
(662) 325-0621
(662) 325-0895
Mailing address
PO BOX 6124, MISSISSIPPI STATE, MS 39762-6124
(662) 325-0621
(662) 325-0895
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
Other
Enumeration date
10/05/2023
Last updated
12/05/2025
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