| Mending Broken Bridges Counseling & Consultation, Llc | |
|
801 E Northside Dr Ste C Clinton MS 39056-3663 | |
| (601) 473-2299 | |
| (601) 473-2258 |
| Full Name | Mending Broken Bridges Counseling & Consultation, Llc |
|---|---|
| Speciality | Counselor |
| Location | 801 E Northside Dr Ste C, Clinton, Mississippi |
| Authorized Official Name and Position | Janice Moore Hopkins (OWNER/THERAPIST) |
| Authorized Official Contact | 6014732299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mending Broken Bridges Counseling & Consultation, Llc 801 E Northside Dr Ste C Clinton MS 39056-3663 Ph: (601) 473-2299 | Mending Broken Bridges Counseling & Consultation, Llc 801 E Northside Dr Ste C Clinton MS 39056-3663 Ph: (601) 473-2299 |
| NPI Number | 1235692534 |
|---|---|
| Provider Enumeration Date | 04/12/2019 |
| Last Update Date | 04/12/2019 |
| Medicare PECOS PAC ID | 8123465838 |
|---|---|
| Medicare Enrollment ID | O20240318001060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235692534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Janice Moore Hopkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467997296 PECOS PAC ID: 9032556741 Enrollment ID: I20240318001212 |
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