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General NPI Number Information
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NPI Number | 1770494536
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Entity Type | Organization
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Legal Business Name | BRACKISH COUNSELING & PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 09/12/2026
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Last Update Date | 09/12/2026
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Provider Practice Location Address
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Address Line | 4836 MAIN ST
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City | MOSS POINT
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State | MS
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Zip | 39563-2700
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Country | US
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Telephone | 228-760-0939
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Fax |
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Provider Business Mailing Address
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Address Line | 121 LINNET DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-9726
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Country | US
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Telephone | 228-760-0939
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARTHA JUNE JUNE KIRBY
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Credential | PLPC
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Telephone | 228-760-0939
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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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