| Family Counseling Services Pllc | |
|
4940 Highway 39 N Meridian MS 39301-1019 | |
| (601) 483-2864 | |
| (601) 483-2806 |
| Full Name | Family Counseling Services Pllc |
|---|---|
| Speciality | Counselor |
| Location | 4940 Highway 39 N, Meridian, Mississippi |
| Authorized Official Name and Position | Rita K Lum (CEO) |
| Authorized Official Contact | 6014832864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Counseling Services Pllc Po Box 3626 Meridian MS 39303-3626 Ph: (601) 483-2864 | Family Counseling Services Pllc 4940 Highway 39 N Meridian MS 39301-1019 Ph: (601) 483-2864 |
| NPI Number | 1427082460 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 05/16/2008 |
| Medicare PECOS PAC ID | 5193890515 |
|---|---|
| Medicare Enrollment ID | O20080820000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427082460 | NPI | - | NPPES |
| 09014459 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Mississippi) | Primary |
| Provider Name | Ricardo Gillispie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699797944 PECOS PAC ID: 0345422481 Enrollment ID: I20110310000107 |
| Provider Name | Tina Darlene Clearman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700142403 PECOS PAC ID: 4789846676 Enrollment ID: I20120511000025 |
| Provider Name | Leigh Z Gillespie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386893717 PECOS PAC ID: 5597996926 Enrollment ID: I20140327000568 |
| Provider Name | Derrick Pringle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518481480 PECOS PAC ID: 0840532719 Enrollment ID: I20190424001198 |
| Provider Name | Susan L Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225795859 PECOS PAC ID: 3678964244 Enrollment ID: I20211216000247 |
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