| Tina J Sullivan Counseling Services Llc | |
|
609 Washington Ave Ocean Springs MS 39564-4633 | |
| (662) 251-3245 | |
| Not Available |
| Full Name | Tina J Sullivan Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 609 Washington Ave, Ocean Springs, Mississippi |
| Authorized Official Name and Position | Tina J Sullivan (OWNER) |
| Authorized Official Contact | 6622513245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tina J Sullivan Counseling Services Llc 609 Washington Ave Ocean Springs MS 39564-4633 Ph: (662) 251-3245 | Tina J Sullivan Counseling Services Llc 609 Washington Ave Ocean Springs MS 39564-4633 Ph: (662) 251-3245 |
| NPI Number | 1124804760 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 09/07/2023 |
| Certification Date | 09/07/2023 |
| Medicare PECOS PAC ID | 0648621490 |
|---|---|
| Medicare Enrollment ID | O20240105003582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124804760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Tina J Sullivan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760126619 PECOS PAC ID: 0446601298 Enrollment ID: I20240105003838 |
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