| |
404 Galleria Dr Ste 4 Oxford MS 38655-4383 | |
(662) 832-2288 | |
(662) 236-9310 |
Full Name | |
---|---|
Speciality | Counselor |
Location | 404 Galleria Dr Ste 4, Oxford, Mississippi |
Authorized Official Name and Position | Joyce S. Mitchell (OWNER) |
Authorized Official Contact | 6628322288 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
404 Galleria Dr Ste 4 Oxford MS 38655-4383 Ph: (662) 832-2288 | 404 Galleria Dr Ste 4 Oxford MS 38655-4383 Ph: (662) 832-2288 |
NPI Number | 1801641527 |
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Provider Enumeration Date | 04/17/2024 |
Last Update Date | 08/25/2024 |
Certification Date | 08/25/2024 |
Medicare PECOS PAC ID | 6103358890 |
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Medicare Enrollment ID | O20241018003251 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801641527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Joyce S. Mitchell |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1346329711 PECOS PAC ID: 9638601321 Enrollment ID: I20241018003385 |
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