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General NPI Number Information
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NPI Number | 1679305650
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Entity Type | Organization
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Legal Business Name | SOWING SEEDS, LLC
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Dates
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Enumeration Date | 08/17/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 114 STONE COVE
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City | CLINTON
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State | MS
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Zip | 39056-5020
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Country | US
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Telephone | 601-572-4268
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Fax | 601-488-5003
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Provider Business Mailing Address
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Address Line | 114 STONE COVE
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City | CLINTON
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State | MS
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Zip | 39056-5020
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Country | US
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Telephone | 601-572-4268
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Fax |
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Authorized Official
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Title or Position | OWNER, MANAGER
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Name | MS. LURETHA ROENEKA KELLY
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Credential | LCSW
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Telephone | 601-572-4268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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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