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General NPI Number Information
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NPI Number | 1811277510
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Entity Type | Organization
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Legal Business Name | MARCH HCT
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 304 EMERALD LANE
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City | HATTIESBURG
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State | MS
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Zip | 39401
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Country | US
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Telephone | 601-268-8796
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Fax | 601-336-7563
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Provider Business Mailing Address
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Address Line | 304 EMERALD LANE
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City | HATTIESBURG
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State | MS
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Zip | 39401
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Country | US
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Telephone | 601-268-8796
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Fax | 601-336-7563
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Authorized Official
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Title or Position | OWNER/PRIMARY THERAPIST
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Name | MRS. SHANNON MICHELLE RAINEY
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Credential | MS, LPC
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Telephone | 601-325-4774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1017
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License Number State | MS
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