Destination Life Llc-S
NPI 1023625894 · Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist · Ellisville, MS
Destination Life Llc-S is a Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist organization in Ellisville, MS (NPI 1023625894).
Provider details
- NPI number
- 1023625894
- Entity type
- Organization
- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Zemelda Carr, Adm(817) 473-1312
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Nursing Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Mental Health Occupational Therapist225XM0800X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Sajourney
Additional practice locations (1)
- 1759 Broad Park Cir S Ste 113Mansfield, TX 76063-7836Phone: (817) 473-1312Fax: (866) 990-2813
Registry dates
- Enumerated
- 2020-09-25
- Last updated
- 2021-07-30
- Certified
- 2021-07-30
Frequently asked questions
- What is Destination Life Llc-S's NPI number?
- Destination Life Llc-S's National Provider Identifier (NPI) is 1023625894, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Destination Life Llc-S?
- Destination Life Llc-S is classified in the NPPES registry as Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Destination Life Llc-S located?
- Destination Life Llc-S's practice location on file with NPPES is 7 Jonathan Way, Ellisville, MS 39437-5195.
- What is Destination Life Llc-S's phone number?
- The practice phone number listed in the NPPES registry for Destination Life Llc-S is (817) 473-1312.
- Who is the authorized official for Destination Life Llc-S?
- The authorized official listed on Destination Life Llc-S's NPPES record is Zemelda Carr, Adm. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Destination Life Llc-S's NPI active?
- Yes — Destination Life Llc-S's NPI (1023625894) is active in the NPPES registry as of the last update on 2021-07-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.