Provider Demographics
NPI:1922818467
Name:HEC MEDICAL
Entity type:Organization
Organization Name:HEC MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:662-536-6210
Mailing Address - Street 1:6858 SWINNEA RD BLDG 7
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-9493
Mailing Address - Country:US
Mailing Address - Phone:662-536-6210
Mailing Address - Fax:228-227-4099
Practice Address - Street 1:6858 SWINNEA RD BLDG 7
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9493
Practice Address - Country:US
Practice Address - Phone:662-536-6210
Practice Address - Fax:228-227-4099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE ENRICHMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty