Provider Demographics
NPI:1245592450
Name:WEBB, JOHN C (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:WEBB
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 REDBUD LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9261
Mailing Address - Country:US
Mailing Address - Phone:601-506-2292
Mailing Address - Fax:
Practice Address - Street 1:105 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-8496
Practice Address - Country:US
Practice Address - Phone:601-506-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1663101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor