| Jade Clinical Supervision And Consultation, Llc | |
|
4780 I 55 Frontage Rd N Ste 100-1204 Jackson MS 39211-5542 | |
| (601) 331-6767 | |
| (601) 861-4909 |
| Full Name | Jade Clinical Supervision And Consultation, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4780 I 55 Frontage Rd N Ste 100-1204, Jackson, Mississippi |
| Authorized Official Name and Position | Jessica Thomas (OWNER/OPERATOR/CEO) |
| Authorized Official Contact | 6013316767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jade Clinical Supervision And Consultation, Llc 4780 I 55 Frontage Rd N Ste 100-1204 Jackson MS 39211-5542 Ph: (601) 331-6767 | Jade Clinical Supervision And Consultation, Llc 4780 I 55 Frontage Rd N Ste 100-1204 Jackson MS 39211-5542 Ph: (601) 331-6767 |
| NPI Number | 1427816644 |
|---|---|
| Provider Enumeration Date | 03/12/2024 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427816644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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