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General NPI Number Information
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NPI Number | 1255959888
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Entity Type | Organization
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Legal Business Name | EMPOWERING MINDS COUNSELING AND CONSULTANT SERVICES,LLC
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 1114 ROBINSON ST # A
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3842
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Country | US
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Telephone | 228-313-6072
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Fax |
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Provider Business Mailing Address
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Address Line | 1955 POPPS FERRY RD APT 1127BB
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City | BILOXI
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State | MS
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Zip | 39532-2031
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Country | US
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Telephone | 228-313-6072
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATESHA TANISE MCINNIS
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Credential | LCSW, ED.S, BC-TMH
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Telephone | 228-313-6072
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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 |
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License Number State |
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