Provider Demographics
NPI:1295469096
Name:CLOSE KNIT COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:CLOSE KNIT COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:769-208-2995
Mailing Address - Street 1:1530 PLANTATION BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2813
Mailing Address - Country:US
Mailing Address - Phone:601-573-9371
Mailing Address - Fax:
Practice Address - Street 1:1530 PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2813
Practice Address - Country:US
Practice Address - Phone:601-573-9371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health