| Carlisle Counseling And Consulting Services Llc | |
|
234 W School St Ridgeland MS 39157-2707 | |
| (601) 559-0599 | |
| Not Available |
| Full Name | Carlisle Counseling And Consulting Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 234 W School St, Ridgeland, Mississippi |
| Authorized Official Name and Position | Shalonda Carlisle (OWNER/THERAPIST) |
| Authorized Official Contact | 6015590599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlisle Counseling And Consulting Services Llc 101 Kenzie Dr Madison MS 39110-7081 Ph: (601) 559-0599 | Carlisle Counseling And Consulting Services Llc 234 W School St Ridgeland MS 39157-2707 Ph: (601) 559-0599 |
| NPI Number | 1598327652 |
|---|---|
| Provider Enumeration Date | 06/28/2019 |
| Last Update Date | 01/07/2020 |
| Certification Date | 01/07/2020 |
| Medicare PECOS PAC ID | 0446685036 |
|---|---|
| Medicare Enrollment ID | O20200108000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598327652 | NPI | - | NPPES |
| 05006289 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shalonda D Carlisle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124462965 PECOS PAC ID: 9537430327 Enrollment ID: I20190530002580 |
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