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General NPI Number Information
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NPI Number | 1215379136
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Entity Type | Organization
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Legal Business Name | THE GROUNDING CENTER, PLLC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 609 WASHINGTON AVE
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-4633
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Country | US
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Telephone | 228-424-7590
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Fax |
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Provider Business Mailing Address
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Address Line | 609 WASHINGTON AVE
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-4633
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Country | US
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Telephone | 228-424-7590
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS PATRICIA JO SEYMOUR
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Credential | LCSW, BC-DMT
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Telephone | 228-424-7590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C5562
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License Number State | MS
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