| East Park Counseling Services Llc | |
|
6855 Crumpler Blvd Ste 201 Olive Branch MS 38654-1938 | |
| (662) 645-2238 | |
| Not Available |
| Full Name | East Park Counseling Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6855 Crumpler Blvd Ste 201, Olive Branch, Mississippi |
| Authorized Official Name and Position | Tricia Hopson (OWNER) |
| Authorized Official Contact | 6626452238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Park Counseling Services Llc 6855 Crumpler Blvd Ste 201 Olive Branch MS 38654-1938 Ph: () - | East Park Counseling Services Llc 6855 Crumpler Blvd Ste 201 Olive Branch MS 38654-1938 Ph: (662) 645-2238 |
| NPI Number | 1730884958 |
|---|---|
| Provider Enumeration Date | 04/05/2023 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Medicare PECOS PAC ID | 0648645374 |
|---|---|
| Medicare Enrollment ID | O20230412000916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730884958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Tricia Stephens Hopson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255047841 PECOS PAC ID: 1557736287 Enrollment ID: I20230807001595 |
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