| Counseling Services Llc | |
|
1905 Mission 66 Ste A Vicksburg MS 39180-3711 | |
| (601) 831-3304 | |
| Not Available |
| Full Name | Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 1905 Mission 66 Ste A, Vicksburg, Mississippi |
| Authorized Official Name and Position | Tonya Hall Smith (LPC/OWNER) |
| Authorized Official Contact | 6018313304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Services Llc 30 Mill Wood Cir Vicksburg MS 39180-1344 Ph: () - | Counseling Services Llc 1905 Mission 66 Ste A Vicksburg MS 39180-3711 Ph: (601) 831-3304 |
| NPI Number | 1538922133 |
|---|---|
| Provider Enumeration Date | 02/05/2024 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Medicare PECOS PAC ID | 1850734617 |
|---|---|
| Medicare Enrollment ID | O20240208001764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538922133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Tonya Smith |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1073866513 PECOS PAC ID: 6002267234 Enrollment ID: I20240111002816 |
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