NPI Details
MISSISSIPPI CENTER FOR AUTISM AND RELATED DEVELOPMENTAL DISABILITIES is a psychologist in Diberville, MS. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. MISSISSIPPI CENTER FOR AUTISM AND RELATED DEVELOPMENTAL DISABILITIES NPI is 1891084414. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
4061 SUZANNE DR
SUITE C
DIBERVILLE, MS
ZIP 39540-735
Phone: (228) 396-4434
The provider's authorized official is Aimee M Tisdale .
The authorized official title is Program Director and has the following contact phone number (228) 806-9936.
The enumeration date for this NPI number is 4/4/2011 and was last updated on 4/4/2011.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103TB0200X | Psychologist | Cognitive & Behavioral | | | No |
| 2 | 103TC2200X | Psychologist | Clinical Child & Adolescent | | | No |
| 3 | 103TM1800X | Psychologist | Intellectual and Developmental Disabilities | | | No |
| 4 | 103TS0200X | Psychologist | School | | | No |
| 5 | 251S00000X | Community/Behavioral Health | | | | No |
| 6 | 103T00000X | Psychologist | | | | Yes |
