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General NPI Number Information
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NPI Number | 1235842428
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Entity Type | Organization
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Legal Business Name | FAITH CHRISTIAN COUNSELING, LLC
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Dates
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Enumeration Date | 01/03/2023
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 1014 N GLOSTER ST STE F
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City | TUPELO
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State | MS
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Zip | 38804-1239
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Country | US
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Telephone | 662-694-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 183 CEDAR CREEK DR
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City | PONTOTOC
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State | MS
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Zip | 38863-2903
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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/COUNSELOR
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Name | LAURA MOORE
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Credential | LPC
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Telephone | 662-694-0260
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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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