Organization
HARVEST AUTISM & BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WILLIS (MANAGER)
(601) 441-4307
Entity
Organization
Contact information
Practice address
338 RAYNES RD, CARSON, MS 39427-6366
(601) 441-4307
(601) 441-4307
Mailing address
338 RAYNES RD, CARSON, MS 39427-6366
(601) 441-4307
(601) 441-4307
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2026
Last updated
03/31/2026
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