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General NPI Number Information
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NPI Number | 1588905939
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Entity Type | Organization
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Legal Business Name | ANCHOR PSYCHOLOGY CENTER, PLLC
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Dates
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Enumeration Date | 03/11/2013
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 2112 BIENVILLE BLVD STE J
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3067
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Country | US
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Telephone | 228-875-1590
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Fax | 228-875-1591
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Provider Business Mailing Address
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Address Line | 2112 BIENVILLE BLVD STE J
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3067
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Country | US
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Telephone | 228-875-1590
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Fax | 228-875-1591
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Authorized Official
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Title or Position | PRINCIPLE
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Name | RUTH M SHOEMAKER, PHD
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Credential | PHD
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Telephone | 228-875-1590
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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 | 1728
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 53938
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0437
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1977
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 46-802
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License Number State | MS
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