Healthcare Provider Details
I. General information
NPI: 1255294013
Provider Name (Legal Business Name): ISSUES OF LIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2025
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2375 MEMPHIS ST STE 206
HERNANDO MS
38632-1757
US
IV. Provider business mailing address
PO BOX 675
NESBIT MS
38651-0675
US
V. Phone/Fax
- Phone: 901-213-6051
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TYRA
ROWELL
Title or Position: CEO
Credential:
Phone: 662-769-2019