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General NPI Number Information
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NPI Number | 1134581028
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL COUNSELING PLLC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 190 W SOUTH ST
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City | HERNANDO
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State | MS
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Zip | 38632-2245
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Country | US
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Telephone | 901-871-9062
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Fax |
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Provider Business Mailing Address
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Address Line | 1737 SANDPIPER CV S
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City | HERNANDO
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State | MS
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Zip | 38632-1631
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Country | US
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Telephone | 901-871-9062
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. DEBORAH WILSON
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Credential | LPC
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Telephone | 901-871-9062
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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 | P0510066
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0837
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License Number State | MS
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