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General NPI Number Information
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NPI Number | 1497191639
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Entity Type | Organization
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Legal Business Name | ISLANDS COUNSELING, LLC
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Dates
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Enumeration Date | 05/15/2013
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 805 HOLCOMB BLVD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3943
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Country | US
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Telephone | 228-324-3244
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Fax |
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Provider Business Mailing Address
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Address Line | 2953 BIENVILLE BLVD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-4305
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Country | US
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Telephone | 228-324-5767
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED COUNSELOR/SUPERVISOR
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Name | MARCIA CRETIN BARKSDALE
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Credential | LPC, NCC
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Telephone | 228-324-3244
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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 | 1148
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License Number State | MS
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