| Pendleton Counseling Center | |
|
403 Old Town Cir Brandon MS 39042-3628 | |
| (601) 201-4111 | |
| (601) 825-1793 |
| Full Name | Pendleton Counseling Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 403 Old Town Cir, Brandon, Mississippi |
| Authorized Official Name and Position | Linda Faye Pendleton (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6012014111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pendleton Counseling Center 403 Old Town Cir Brandon MS 39042-3628 Ph: (601) 201-4111 | Pendleton Counseling Center 403 Old Town Cir Brandon MS 39042-3628 Ph: (601) 201-4111 |
| NPI Number | 1548869712 |
|---|---|
| Provider Enumeration Date | 10/20/2020 |
| Last Update Date | 10/20/2020 |
| Certification Date | 10/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548869712 | NPI | - | NPPES |
| 06635891 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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