Linda S Tello, LMFT | |
1414 Cherry St, Vicksburg, MS 39180-3218 | |
(601) 636-5703 | |
(769) 230-3039 |
Full Name | Linda S Tello |
---|---|
Gender | Female |
Speciality | Marriage & Family Therapist |
Location | 1414 Cherry St, Vicksburg, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902488851 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | T0083 (Mississippi) | Secondary |
106H00000X | Marriage & Family Therapist | 000087 (Mississippi) | Primary |
Entity Name | Grace Christian Counseling Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447295654 PECOS PAC ID: 0749285070 Enrollment ID: O20240130002733 |
Mailing Address | Practice Location Address |
---|---|
Linda S Tello, LMFT 1414 Cherry St, Vicksburg, MS 39180-3218 Ph: (601) 636-5703 | Linda S Tello, LMFT 1414 Cherry St, Vicksburg, MS 39180-3218 Ph: (601) 636-5703 |
Denetra Quinnette Taylor, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 1905a Mission 66, Vicksburg, MS 39180 Phone: 601-259-6566 | |
Michelle R Johnson, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2707 Jeanette St, Vicksburg, MS 39180 Phone: 601-218-7041 | |
Mrs. Rhonda C Denman, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1905b Mission 66 Ste 4, Vicksburg, MS 39180 Phone: 601-529-6007 |