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General NPI Number Information
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NPI Number | 1053025163
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Entity Type | Organization
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Legal Business Name | THYME TO HEAL COUNSELING & WELLNESS
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 404 FONTAINE PL STE 104
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City | RIDGELAND
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State | MS
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Zip | 39157-5229
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Country | US
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Telephone | 769-278-2584
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Fax |
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Provider Business Mailing Address
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Address Line | 400 FLANAGAN WAY
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City | BRANDON
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State | MS
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Zip | 39047-6764
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Country | US
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Telephone | 601-624-7392
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | QOUSTON D ARMISTAD
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Credential | LCSW
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Telephone | 601-624-7392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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