MEDICARE: JOSEPH BEN PIERCY NCC, LPC, LMHC, CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	ADO8R-019P	MS
2	101YM0800X	Mental Health Counselor	MH-5221	FL
3	101YP2500X	Professional Counselor	PC-2072	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1214764	OTHER	MS	MS SECRETARY OF STATE BUSINESS ID

General Provider Information

NPI Number	:	1063735033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH BEN PIERCY NCC, LPC, LMHC, CADC

Provider Business Mailing Address
First Line	:	4611 JONATHAN DRIVE
Second Line	:	PSYCHOLOGICAL EDUCATION INCORPORATED
City	:	HORN LAKE
State	:	MS
Zip	:	38637-5392
Country	:	US
Telephone Number	:	302-222-7235
Fax Number	:

Provider Business Practice Location Address
First Line	:	4611 JONATHAN DRIVE
Second Line	:	PSYCHOLOGICAL EDUCATION INCORPORATED
City	:	HORN LAKE
State	:	MS
Zip	:	38637-5392
Country	:	US
Telephone Number	:	302-222-7235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2010
Last Update Date	:	06/15/2020

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