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General NPI Number Information
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NPI Number | 1912768623
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Entity Type | Organization
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Legal Business Name | MINDSET MATTER LLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 6760 HWY 98 SUITE 1
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone | 601-402-5137
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Fax |
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Provider Business Mailing Address
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Address Line | 6760 HWY 98 SUITE 1
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone | 601-402-5137
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PAMELA JOYCE PHIPPS
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Credential | LPC
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Telephone | 601-402-5137
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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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