Healthcare Provider Details

I. General information

NPI: 1235250051
Provider Name (Legal Business Name): TINA DYE LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 N MADISON ST
TUPELO MS
38804-3807
US

IV. Provider business mailing address

211 N MADISON ST
TUPELO MS
38804-3807
US

V. Phone/Fax

Practice location:
  • Phone: 662-339-5165
  • Fax:
Mailing address:
  • Phone: 662-339-5165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: