Organization
INNOVATIVE BEHAVIORALS SERVICES, INC.
Active
Other names
IBS, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOROTHY J MCGILL PHD (COO)
(601) 952-0894
Entity
Organization
Contact information
Practice address
357 TOWNE CENTER BLVD, SUITE # 100, RIDGELAND, MS 39157-4837
(601) 952-0894
(601) 952-0836
Mailing address
357 TOWNE CENTER BLVD, SUITE # 100, RIDGELAND, MS 39157-4837
(601) 952-0894
(601) 952-0836
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH0186
MS
103TC0700X
Clinical Psychologist
34561
MS
1041C0700X
Clinical Social Worker
Primary
C6034
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015770
—
MS
01
—
587443922
BLUE CROSS BLUE SHIELD
MS
Enumeration date
07/31/2006
Last updated
05/06/2013
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