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General NPI Number Information
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NPI Number | 1831784453
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Entity Type | Organization
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Legal Business Name | PEACEFUL SOLUTIONS THERAPY, LLC
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 460 BRIARWOOD DR # 400-52
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City | JACKSON
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State | MS
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Zip | 39206-3051
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Country | US
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Telephone | 601-596-2625
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 W GOVERNMENT ST STE E
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City | BRANDON
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State | MS
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Zip | 39042-2420
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Country | US
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Telephone | 769-234-5409
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Fax |
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Authorized Official
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Title or Position | LCSW/ OWNER
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Name | KYNDEL MARIE LINDSEY
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Credential | LCSW
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Telephone | 601-596-2625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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