Provider Demographics
NPI:1558529289
Name:STARKVILLE COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:STARKVILLE COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:FYE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:662-323-5588
Mailing Address - Street 1:205 S LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3209
Mailing Address - Country:US
Mailing Address - Phone:662-323-5588
Mailing Address - Fax:662-323-5552
Practice Address - Street 1:205 S LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3209
Practice Address - Country:US
Practice Address - Phone:662-323-5588
Practice Address - Fax:662-323-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0745101YP2500X
MS1128101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty