Healthcare Provider Details

I. General information

NPI: 1730098443
Provider Name (Legal Business Name): DOING LIFE WELL INTEGRATIVE HEALTH AND CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 COUNTY ROAD 1562
TUPELO MS
38804-8549
US

IV. Provider business mailing address

PO BOX 404
TUPELO MS
38802-0404
US

V. Phone/Fax

Practice location:
  • Phone: 601-337-0294
  • Fax:
Mailing address:
  • Phone: 601-337-0294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. REGINA LACKING
Title or Position: FOUNDER/SOLE MEMBER
Credential: LCSW
Phone: 601-337-0294