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General NPI Number Information
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NPI Number | 1730039843
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Entity Type | Organization
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Legal Business Name | FAMILY REDEFINED COUNSELING SERVICES
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 15 PROFESSIONAL PKWY STE 100
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City | HATTIESBURG
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State | MS
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Zip | 39402-2647
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Country | US
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Telephone | 601-768-4242
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Fax | 601-768-2429
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Provider Business Mailing Address
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Address Line | PO BOX 15324
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City | HATTIESBURG
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State | MS
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Zip | 39404-5324
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Country | US
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Telephone | 601-768-4242
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Fax | 601-448-6947
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | DR. LEWIS ANTHONY BULLOCK
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Credential | DPC
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Telephone | 601-768-4242
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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 |
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License Number State |
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