Healthcare Provider Details

I. General information

NPI: 1437012879
Provider Name (Legal Business Name): BEAUTY FOR ASHES COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9356 GOODMAN RD UNIT 3
OLIVE BRANCH MS
38654-1700
US

IV. Provider business mailing address

9356 GOODMAN RD UNIT 3
OLIVE BRANCH MS
38654-1700
US

V. Phone/Fax

Practice location:
  • Phone: 662-469-6270
  • Fax: 855-975-2540
Mailing address:
  • Phone: 662-469-6270
  • Fax: 855-975-2540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KARISSA COLEMAN
Title or Position: OWNER/THERAPIST
Credential: LPC
Phone: 901-734-7050