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General NPI Number Information
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NPI Number | 1225675333
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Entity Type | Organization
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Legal Business Name | SWEET LIFE COUNSELING LLC
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 665 S PEAR ORCHARD RD STE 106-1165
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City | RIDGELAND
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State | MS
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Zip | 39157-4861
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Country | US
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Telephone | 601-832-2015
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Fax |
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Provider Business Mailing Address
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Address Line | 11 CLAY LEE JOHNSON DR
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City | OAK VALE
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State | MS
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Zip | 39656-7015
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Country | US
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Telephone |
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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 | MARISSA KENT
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Credential | LPC
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Telephone | 601-283-2015
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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 |
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License Number State |
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