Desoto Family Counseling Center Pllc

LBN: Desoto Family Counseling Center Pllc
Desoto Family Counseling Center Pllc is an health care organization with primary practice located at 8626 Airways Blvd , Southaven MS 38671-2603. The organization recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Allopathic & Osteopathic Physicians / Psychiatry, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is the primary health care specialty. Desoto Family Counseling Center Pllc can be contacted via phone (662) 772-5937, or through Wood, Anthony Jerome via phone (662) 772-5937.

Contact Information

Primary practice address
8626 Airways Blvd Southaven MS 38671-2603
Phone: (662) 772-5937
Fax: (662) 772-5940
Website:
Map and Directions
Authorized official contact:
Name: Wood, Anthony Jerome LPC-S
Phone: (662) 772-5937

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X Mississippi
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X
Agencies / Community/Behavioral Health 251S00000X 1326 Mississippi

Profile Details

NPI number 1912214792
LBN Legal business name Desoto Family Counseling Center Pllc
DBA Doing business as
Authorized official Wood, Anthony Jerome LPC-S
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2010
Last updated Feb 24th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912214792 NPPES
Mississippi MEDICAID 02332763
Mississippi MEDICAID 03458834
Mississippi MEDICAID 09250853
Mississippi MEDICAID 04057773
Mississippi MEDICAID 04073099
Mississippi MEDICAID 09485302
Mississippi MEDICAID 1558401521
Mississippi MEDICAID 01128006
Mississippi MEDICAID 03322249
Mississippi MEDICAID 03350341
Mississippi MEDICAID 05103380
Mississippi MEDICAID 05476356
Mississippi MEDICAID 09588552
Mississippi MEDICAID 00432297
Mississippi MEDICAID 01924277
Mississippi MEDICAID 08579847

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