Healthcare Provider Details

I. General information

NPI: 1053970970
Provider Name (Legal Business Name): MARISA FINLAYSON P-LPC, NCC, PCMHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 HIGHWAY 80 W STE R
CLINTON MS
39056-4108
US

IV. Provider business mailing address

604 HIGHWAY 80 W STE R
CLINTON MS
39056-4108
US

V. Phone/Fax

Practice location:
  • Phone: 601-473-2106
  • Fax: 601-473-2150
Mailing address:
  • Phone: 601-473-2106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3154
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: