Healthcare Provider Details

I. General information

NPI: 1922933142
Provider Name (Legal Business Name): YOLANDA MONIQUE MORTON NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 ELM ST
MOUND BAYOU MS
38762-5502
US

IV. Provider business mailing address

PO BOX 648
SHELBY MS
38774-0648
US

V. Phone/Fax

Practice location:
  • Phone: 662-404-8840
  • Fax:
Mailing address:
  • Phone: 601-201-5266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number173762
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: