Healthcare Provider Details

I. General information

NPI: 1033076922
Provider Name (Legal Business Name): NATURES NOOK COUNSELING AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N SPRING ST
TUPELO MS
38804-3922
US

IV. Provider business mailing address

PO BOX 1479
OXFORD MS
38655-1479
US

V. Phone/Fax

Practice location:
  • Phone: 662-316-6433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGIE ROSS
Title or Position: OFFICE MANAGER
Credential:
Phone: 662-401-0642