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General NPI Number Information
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NPI Number | 1871924787
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Entity Type | Organization
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Legal Business Name | JACKSON-CALHOUN COUNSELING SERVICES, INC
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Dates
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Enumeration Date | 12/02/2013
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 2860 HIGHWAY 71 SUITE A
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City | MARIANNA
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State | FL
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Zip | 32446-1867
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Country | US
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Telephone | 850-482-0019
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Fax | 850-482-0015
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Provider Business Mailing Address
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Address Line | 2860 HIGHWAY 71 SUITE A
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City | MARIANNA
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State | FL
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Zip | 32446-1867
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Country | US
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Telephone | 850-482-0019
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Fax | 850-482-0015
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MELISSA KAY KIRKLAND
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Credential |
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Telephone | 850-323-0543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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