=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982086641
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TURNING POINT COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2015
-----------------------------------------------------
Last Update Date | 06/18/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 940 EBENEZER BLVD SUITE B
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-863-9430
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 137 HIGHWOODS BLVD
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39110-7423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-863-9430
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. MARK T HAGWOOD
-----------------------------------------------------
Credential | DPC
-----------------------------------------------------
Telephone | 601-863-9430
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 1924
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------