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General NPI Number Information
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NPI Number | 1023903341
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Entity Type | Organization
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Legal Business Name | CHAMBLISS COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2076 GRAVEL HILL RD
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City | FAYETTE
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State | MS
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Zip | 39069-5057
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Country | US
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Telephone | 601-809-6968
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Fax | 601-610-7147
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Provider Business Mailing Address
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Address Line | 2076 GRAVEL HILL RD
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City | FAYETTE
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State | MS
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Zip | 39069-5057
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Country | US
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Telephone | 601-809-6968
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Fax | 601-610-7147
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Authorized Official
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Title or Position | LPC, OWNER
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Name | MISS SHARRON CHAMBLISS
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Credential | M.S.ED, LPC , NCC
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Telephone | 601-748-4214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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