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Contact Information

JAMARCUS K CAPTVILLE SR
433 WINTER ST
LUCEDALE, MS39452-6607
 Phone: 225-877-8566
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Service

103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JAMARCUS K CAPTVILLE SR · (Male)

NPI Number 1760293476
Status Active
Credentials
Entity Individual
Enumeration date 01/14/2025
Last updated 01/14/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • LA Medicaid 1386450104
  • MS Medicaid 1386450104
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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