MEDICARE: STORY COUNSELING, PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	1895	MS

General Provider Information

NPI Number	:	1568827863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STORY COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	1755 LELIA DR
Second Line	:	SUITE 105
City	:	JACKSON
State	:	MS
Zip	:	39216-4828
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 LELIA DR
Second Line	:	SUITE 105
City	:	JACKSON
State	:	MS
Zip	:	39216-4828
Country	:	US
Telephone Number	:	662-469-6127
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROPRIETOR
Name	:	MR. WILLIAM FELTON MCNEESE JR.
Credential	:	LPC
Telephone Number	:	662-469-6127

Provider Enumeration Date	:	12/31/2015
Last Update Date	:	12/31/2015

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