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General NPI Number Information
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NPI Number | 1679185136
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Entity Type | Organization
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Legal Business Name | WHERE POSITIVITY GROWS
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 121 HANOVER ST
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City | MADISON
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State | MS
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Zip | 39110-6028
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Country | US
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Telephone | 662-571-6149
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Fax |
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Provider Business Mailing Address
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Address Line | 121 HANOVER ST
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City | MADISON
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State | MS
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Zip | 39110-6028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. AMANDA WHITE
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Credential | LCSW
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Telephone | 662-571-6149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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