Healthcare Provider Details

I. General information

NPI: 1770490575
Provider Name (Legal Business Name): GROWTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 S THOMAS ST STE 104
TUPELO MS
38801-5312
US

IV. Provider business mailing address

144 S THOMAS ST STE 104
TUPELO MS
38801-5312
US

V. Phone/Fax

Practice location:
  • Phone: 662-871-5742
  • Fax: 662-620-7106
Mailing address:
  • Phone: 662-871-5742
  • Fax: 662-620-7106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER M DICKERSON
Title or Position: OWNER
Credential: LPC
Phone: 662-871-5742