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General NPI Number Information
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NPI Number | 1245837756
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Entity Type | Individual
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Provider Name | JERRI GLEDHILL PHD, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 241 SUNNYBROOK RD
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City | RIDGELAND
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State | MS
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Zip | 39157-2206
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Country | US
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Telephone | 769-231-9414
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Fax |
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Provider Business Mailing Address
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Address Line | 158 WESTLAKE CIR
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City | MADISON
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State | MS
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Zip | 39110-1808
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Country | US
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Telephone | 601-906-4434
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2622
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License Number State | MS
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