Provider Demographics
NPI:1346718152
Name:A QUIET PLACE COUNSELING, PLLC
Entity Type:Organization
Organization Name:A QUIET PLACE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:901-500-8865
Mailing Address - Street 1:30 WREN ST
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-4230
Mailing Address - Country:US
Mailing Address - Phone:901-500-8865
Mailing Address - Fax:
Practice Address - Street 1:190 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-2245
Practice Address - Country:US
Practice Address - Phone:662-214-9912
Practice Address - Fax:662-912-9082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty