Provider Demographics
NPI:1013225663
Name:CALVIN, JEMECIA N (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JEMECIA
Middle Name:N
Last Name:CALVIN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 W SUNFLOWER RD
Mailing Address - Street 2:DSU BOX 2211
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38733-0001
Mailing Address - Country:US
Mailing Address - Phone:662-846-4364
Mailing Address - Fax:662-846-4549
Practice Address - Street 1:1003 W SUNFLOWER RD
Practice Address - Street 2:EWING HALL ROOM 338-DELTA STATE UNIVERSITY
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38733-0001
Practice Address - Country:US
Practice Address - Phone:662-721-6756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1385101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional