OrganizationActive
Indianola Clinic, LLC
NPI 1164964565 · Mental Health Clinic/Center (Including Community Mental Health Center) · Leland, MS
Provider details
- NPI number
- 1164964565
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Henry Womack, Vp of Administration(662) 686-3916
Specialties & taxonomies
Ambulatory Health Care Facilities
- Counselor101Y00000X
Behavioral Health & Social Service Providers
- Social Worker104100000X
Behavioral Health & Social Service Providers
Practice location
201 Baker Blvd
Leland, MS 38756-3401
Phone: (662) 686-4121
Fax: (662) 686-4770
Approximate (ZIP-level) locationGet directions
Mailing address
201 Baker Blvd
Leland, MS 38756-3401
Other names (DBA / former)
- Doing business as
- Leland Medical Clinic
Registry dates
- Enumerated
- 2016-11-16
- Last updated
- 2017-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.