Healthcare Provider Details

I. General information

NPI: 1609182435
Provider Name (Legal Business Name): BARBARA CAROL RAGEN LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 N HILLS ST
MERIDIAN MS
39307-2903
US

IV. Provider business mailing address

PO BOX 4128
MERIDIAN MS
39304-4128
US

V. Phone/Fax

Practice location:
  • Phone: 601-581-7562
  • Fax: 601-581-7676
Mailing address:
  • Phone: 601-581-7614
  • Fax: 601-581-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0857
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: