| Laureate' Counseling & Personal Development, Llc | |
|
510 George St Ste 214 Jackson MS 39202-3029 | |
| (769) 216-0815 | |
| Not Available |
| Full Name | Laureate' Counseling & Personal Development, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 510 George St Ste 214, Jackson, Mississippi |
| Authorized Official Name and Position | Tishounna Knox Sulton (OWNER/CLINICAL PSYCHOTHERAPIST) |
| Authorized Official Contact | 7692160815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laureate' Counseling & Personal Development, Llc 510 George St Ste 214 Jackson MS 39202-3029 Ph: (769) 216-0815 | Laureate' Counseling & Personal Development, Llc 510 George St Ste 214 Jackson MS 39202-3029 Ph: (769) 216-0815 |
| NPI Number | 1194387787 |
|---|---|
| Provider Enumeration Date | 07/03/2019 |
| Last Update Date | 07/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194387787 | NPI | - | NPPES |
| 00259005 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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