Healthcare Provider Details

I. General information

NPI: 1558802215
Provider Name (Legal Business Name): TRI-SIGHT COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 02/16/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 ELM AVENUE
MOUND BAYOU MS
38762-5502
US

IV. Provider business mailing address

1268 MEMORIAL DR.
CLEVELAND MS
38732-9545
US

V. Phone/Fax

Practice location:
  • Phone: 662-404-8840
  • Fax: 662-590-7605
Mailing address:
  • Phone: 662-719-1202
  • Fax: 662-590-7605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1159
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1159
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1159
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number166276
License Number StateMS
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LORITA LYNN HARRIS
Title or Position: OWNER/PRACTITIONER
Credential: ED.D, LPC-S
Phone: 662-719-1202