| Fair Park Counseling Pllc | |
|
210 E Main St Ste 2c Tupelo MS 38804-4017 | |
| (662) 760-0052 | |
| (662) 495-4080 |
| Full Name | Fair Park Counseling Pllc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 210 E Main St Ste 2c, Tupelo, Mississippi |
| Authorized Official Name and Position | Kelly W Ferguson (CEO) |
| Authorized Official Contact | 6627600052 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fair Park Counseling Pllc 210 E Main St Ste 2c Tupelo MS 38804-4017 Ph: (662) 760-0052 | Fair Park Counseling Pllc 210 E Main St Ste 2c Tupelo MS 38804-4017 Ph: (662) 760-0052 |
| NPI Number | 1730661331 |
|---|---|
| Provider Enumeration Date | 08/30/2018 |
| Last Update Date | 11/07/2021 |
| Certification Date | 11/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730661331 | NPI | - | NPPES |
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