Healthcare Provider Details

I. General information

NPI: 1114849346
Provider Name (Legal Business Name): BEARING TREE CREEK CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 FRANKLIN RD
GOODMAN MS
39079-9527
US

IV. Provider business mailing address

661 FRANKLIN RD
GOODMAN MS
39079-9527
US

V. Phone/Fax

Practice location:
  • Phone: 662-639-0132
  • Fax:
Mailing address:
  • Phone: 662-639-0132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RONEDA LOWE
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S.,CCC-SLP
Phone: 662-639-0132