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Organization

Destination Life Llc-S

NPI Record: ActiveClinical Nurse Specialist — Psychiatric/Mental Health, Child & Adolescent
NPI1023625894
Ellisville, Mississippi

Provider's NPPES record last updated: July 30, 2021

Overview

Entity Type
Organization
NPI
1023625894
Primary Specialty
Clinical Nurse Specialist — Psychiatric/Mental Health, Child & Adolescent
Practice Location
Ellisville, Mississippi
Organization Subpart
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 17, 2026, 10:00 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Clinical Nurse Specialist

    Psychiatric/Mental Health, Child & Adolescent

    Physician Assistants & Advanced Practice Nursing Providers

    Primary

    Definition to come...

    Taxonomy code 364SP0807X
  • Social Worker

    Clinical

    Behavioral Health & Social Service Providers

    A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

    Taxonomy code 1041C0700X
  • Registered Nurse

    Psychiatric/Mental Health, Child & Adolescent

    Nursing Service Providers

    Definition to come...

    Taxonomy code 163WP0807X
  • Occupational Therapist

    Respiratory, Developmental, Rehabilitative and Restorative Service Providers

    An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

    Taxonomy code 225X00000X
  • Occupational Therapist

    Mental Health

    Respiratory, Developmental, Rehabilitative and Restorative Service Providers

    Occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to engage in normal daily occupations (work, home, family life, school, leisure). Occupational therapists provide particular emphasis on interventions that result in improved quality of life and decrease hospitalization.

    Taxonomy code 225XM0800X
  • Clinic/Center

    Primary Care

    Ambulatory Health Care Facilities

    Definition to come...

    Taxonomy code 261QP2300X
  • Clinic/Center

    Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

    Ambulatory Health Care Facilities

    Definition to come...

    Taxonomy code 261QR0401X
  • Clinical Medical Laboratory

    Laboratories

    (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

    Taxonomy code 291U00000X
  • Nurse Practitioner

    Physician Assistants & Advanced Practice Nursing Providers

    (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

    Taxonomy code 363L00000X
  • Nurse Practitioner

    Community Health

    Physician Assistants & Advanced Practice Nursing Providers

    Definition to come...

    Taxonomy code 363LC1500X
  • Nurse Practitioner

    Family

    Physician Assistants & Advanced Practice Nursing Providers

    Definition to come...

    Taxonomy code 363LF0000X
  • Nurse Practitioner

    Psychiatric/Mental Health

    Physician Assistants & Advanced Practice Nursing Providers

    Definition to come...

    Taxonomy code 363LP0808X
  • Nurse Practitioner

    Women's Health

    Physician Assistants & Advanced Practice Nursing Providers

    Definition to come...

    Taxonomy code 363LW0102X
  • Clinical Nurse Specialist

    Physician Assistants & Advanced Practice Nursing Providers

    A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration.

    Taxonomy code 364S00000X
  • Clinical Nurse Specialist

    Psychiatric/Mental Health

    Physician Assistants & Advanced Practice Nursing Providers

    Definition to come...

    Taxonomy code 364SP0808X

Practice Locations

Practice Location

7 Jonathan Way

Ellisville, Mississippi 39437-5195

Phone: (817) 473-1312

Additional Practice Location

1759 Broad Park Cir S Ste 113

Mansfield, Texas 76063-7836

Phone: (817) 473-1312

Fax: (866) 990-2813

Other Names

  • SajourneyReported July 30, 2021

Record Information

Enumeration Date
September 25, 2020
Provider's NPPES Record Last Updated
July 30, 2021
Certification Date
July 30, 2021
NPISignal NPPES Dataset
August 2026

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