| Foundations Counseling Of Byram, Llc | |
|
1108 Ponderosa Dr Terry MS 39170-9416 | |
| (601) 613-8098 | |
| Not Available |
| Full Name | Foundations Counseling Of Byram, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1108 Ponderosa Dr, Terry, Mississippi |
| Authorized Official Name and Position | Christopher S Cothern (OWNER) |
| Authorized Official Contact | 6016138098 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Counseling Of Byram, Llc 1108 Ponderosa Dr Terry MS 39170-9416 Ph: (601) 613-8098 | Foundations Counseling Of Byram, Llc 1108 Ponderosa Dr Terry MS 39170-9416 Ph: (601) 613-8098 |
| NPI Number | 1588950489 |
|---|---|
| Provider Enumeration Date | 06/20/2011 |
| Last Update Date | 06/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588950489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0570 (Mississippi) | Primary |
Tf Community Mental Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1458 Moncure Marble Rd, Terry, MS 39170 Phone: 601-878-8040 Fax: 601-878-8034 |