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General NPI Number Information
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NPI Number | 1013277680
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Entity Type | Organization
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Legal Business Name | SUNSHINE MENTAL HEALTH COUNSELING SERVICE, LLC
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 2800 YOUREE DR BLDG B SUITE 426
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City | SHREVEPORT
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State | LA
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Zip | 71104-3661
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Country | US
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Telephone | 318-617-4385
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 YOUREE DR BLDG B SUITE 426
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City | SHREVEPORT
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State | LA
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Zip | 71104-3661
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Country | US
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Telephone | 318-617-4385
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. JANICE HORTON RELIFORD
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Credential | LPC-S, LMFT,NCC,BCC
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Telephone | 318-617-4385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2575
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License Number State | LA
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