Provider Demographics
NPI:1306377684
Name:WESTMINSTER PRESBYTERIAN CHURCH
Entity Type:Organization
Organization Name:WESTMINSTER PRESBYTERIAN CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OF COUNSELING MINISTRY
Authorized Official - Prefix:
Authorized Official - First Name:MISCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LMFT
Authorized Official - Phone:662-451-9943
Mailing Address - Street 1:804 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-3100
Mailing Address - Country:US
Mailing Address - Phone:662-451-9943
Mailing Address - Fax:
Practice Address - Street 1:804 E PARK AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-3100
Practice Address - Country:US
Practice Address - Phone:662-451-9943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2137101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty