Provider Demographics
NPI:1225675333
Name:SWEET LIFE COUNSELING LLC
Entity Type:Organization
Organization Name:SWEET LIFE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:601-283-2015
Mailing Address - Street 1:11 CLAY LEE JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:OAK VALE
Mailing Address - State:MS
Mailing Address - Zip Code:39656-7015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:665 S PEAR ORCHARD RD STE 106-1165
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4861
Practice Address - Country:US
Practice Address - Phone:601-832-2015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty