Provider Demographics
NPI:1093214751
Name:LINDA SWEEZER ENTERPRISES, LLC
Entity Type:Organization
Organization Name:LINDA SWEEZER ENTERPRISES, LLC
Other - Org Name:THE PEACE PLACE COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SWEEZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-218-1322
Mailing Address - Street 1:PO BOX 820364
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39182-0364
Mailing Address - Country:US
Mailing Address - Phone:601-218-1322
Mailing Address - Fax:855-540-0718
Practice Address - Street 1:1301 HOLLY ST
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-3665
Practice Address - Country:US
Practice Address - Phone:601-630-3362
Practice Address - Fax:855-540-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSCO962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty