| Magnolia Bloom Counseling, Llc | |
|
4063 Ginger Dr Ste D Diberville MS 39540-3705 | |
| (985) 250-1614 | |
| Not Available |
| Full Name | Magnolia Bloom Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4063 Ginger Dr Ste D, Diberville, Mississippi |
| Authorized Official Name and Position | Valerie Joiner (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2282240984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Bloom Counseling, Llc 11079 Oakcrest Dr Diberville MS 39540-2368 Ph: (228) 224-0984 | Magnolia Bloom Counseling, Llc 4063 Ginger Dr Ste D Diberville MS 39540-3705 Ph: (985) 250-1614 |
| NPI Number | 1457939985 |
|---|---|
| Provider Enumeration Date | 03/29/2021 |
| Last Update Date | 03/29/2021 |
| Certification Date | 03/29/2021 |
| Medicare PECOS PAC ID | 9436567948 |
|---|---|
| Medicare Enrollment ID | O20210422001645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457939985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Valerie Cascile Joiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417457300 PECOS PAC ID: 0345658852 Enrollment ID: I20210422001720 |
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