Provider Demographics
NPI:1417271875
Name:UNIVERSITY OF MISSISSIPPI COUNSELING CENTER
Entity Type:Organization
Organization Name:UNIVERSITY OF MISSISSIPPI COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KREEGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:662-915-3784
Mailing Address - Street 1:ALL AMERICAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38677-1847
Mailing Address - Country:US
Mailing Address - Phone:662-915-3784
Mailing Address - Fax:662-915-7831
Practice Address - Street 1:ALL AMERICAN DRIVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38677-1847
Practice Address - Country:US
Practice Address - Phone:662-915-3784
Practice Address - Fax:662-915-7831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSLMSW251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health