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General NPI Number Information
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NPI Number | 1811565625
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Entity Type | Organization
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Legal Business Name | MASTERPIECE COUNSELING AND HEALTH SERVICES, PLLC
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 6943 OAK FOREST DR STE B
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-1976
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Country | US
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Telephone | 662-804-9140
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Fax |
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Provider Business Mailing Address
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Address Line | 6943 OAK FOREST DR STE B
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-1976
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Country | US
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Telephone | 662-874-6921
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Fax | 662-932-2921
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Authorized Official
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Title or Position | COUNSELOR
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Name | CARISHA C WILLIAMS
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Credential | LPC
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Telephone | 662-874-6921
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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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