| Mr James Edwin Blackmon, LPC | |
|
302 S Spring St, Tupelo, MS 38804-4822 | |
| (662) 205-0098 | |
| (662) 495-4079 |
| Full Name | Mr James Edwin Blackmon |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 302 S Spring St, Tupelo, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376175521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0177 (Mississippi) | Primary |
| Entity Name | Heale Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093410243 PECOS PAC ID: 7416316880 Enrollment ID: O20230703000387 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr James Edwin Blackmon, LPC 306 Timber Cv, Oxford, MS 38655-5871 Ph: (662) 801-0271 | Mr James Edwin Blackmon, LPC 302 S Spring St, Tupelo, MS 38804-4822 Ph: (662) 205-0098 |
Tiffany Brown, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 Fax: 662-680-6416 | |
Alyssa Bridges, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 | |
Caitlyn Capps, M.S.,NCC,LPC/MHSP-T Counselor Medicare: Not Enrolled in Medicare Practice Location: Po Box 2792, Tupelo, MS 38803 Phone: 731-472-0395 | |
Centrell Gardner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 | |
Kayla Harris, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-810-4125 | |
Keyaira Standifer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2434 S Eason Blvd, Tupelo, MS 38804 Phone: 662-640-4595 | |
Mrs. Dorothy Elder Ford, Counselor Medicare: Not Enrolled in Medicare Practice Location: Region Iii Mental Health Center, 2434 South Eason Blvd, Tupelo, MS 38804 Phone: 662-844-1717 Fax: 662-680-6416 |