Destination Life Llc-s
Psychiatric/Mental Health Clinical Nurse Specialist in Ellisville, Mississippi
NPI 1023625894
Destination Life Llc-s is a Psychiatric/Mental Health Clinical Nurse Specialist based in Arlington, MS and is specialized in Psychiatric/Mental Health. Destination Life Llc-s practices in Ellisville, MS. The NPI Number for Destination Life Llc-s is 1023625894 and holds a License No. (Mississippi).
The current practice location address for Destination Life Llc-s is 7 Jonathan Way, Ellisville, MS and can be reached out via phone at 817-473-1312 and via fax at 866-990-2813.
Location: 7 Jonathan Way, Ellisville, MS, 76018-0952
Provider Profile Details
NPI Number
1023625894
Provider Name
Destination Life Llc-s
Credential
Provider Entity Type
Organization
Address
7 Jonathan Way, Ellisville, MS, 76018-0952
Phone Number
817-473-1312
Fax Number
866-990-2813
Provider Enumeration Date
09/25/2020
Last Update Date
03/13/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03320311 | 05 | MS | |
| 25D2200016 | 01 | MS | CLIA |
| 1C5803 | 01 | TX | GROUP |
Provider Business Practice Location Address Details
Address
7 Jonathan Way
City
State
Zip
39437-5195
Phone Number
817-473-1312
Fax Number
866-990-2813
Provider Business Mailing Address Details
Address
7 Jonathan Way
City
State
Zip
39437-5195
Phone Number
817-473-1312
Fax Number
866-990-2813
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Social Worker
Speciality
Clinical
Taxonomy
License No.
()
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Provider's Taxonomy Details 2
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health, Child & Adolescent
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 3
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Occupational Therapist
Speciality
-
Taxonomy
License No.
()
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Provider's Taxonomy Details 4
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Occupational Therapist
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to engage in normal daily occupations (work, home, family life, school, leisure). Occupational therapists provide particular emphasis on interventions that result in improved quality of life and decrease hospitalization.
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 6
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 7
Type
Laboratories
Classification
Clinical Medical Laboratory
Speciality
-
Taxonomy
License No.
()
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Provider's Taxonomy Details 8
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
License No.
()
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Provider's Taxonomy Details 9
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Community Health
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 10
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 11
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 12
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Women's Health
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 13
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
-
Taxonomy
License No.
()
Definition
A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration.
Provider's Taxonomy Details 14
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Psychiatric/Mental Health, Child & Adolescent
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 15
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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