=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669238655
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRIGHTER HORIZONS COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2024
-----------------------------------------------------
Last Update Date | 02/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 431 SADDLEBROOK DR
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39305-9132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-480-5402
-----------------------------------------------------
Fax | 601-207-5096
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8427
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39303-8427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-480-5402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/COUNSELOR
-----------------------------------------------------
Name | DR. MARY ZETTLER
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 601-480-5402
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------