Provider Demographics
NPI:1598423329
Name:ENDLESS POSSIBILITIES COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:ENDLESS POSSIBILITIES COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, NCC, BC-TMH
Authorized Official - Phone:601-613-6268
Mailing Address - Street 1:4038 GLENNOAK DR
Mailing Address - Street 2:
Mailing Address - City:BYRAM
Mailing Address - State:MS
Mailing Address - Zip Code:39272-9384
Mailing Address - Country:US
Mailing Address - Phone:601-672-9277
Mailing Address - Fax:
Practice Address - Street 1:4038 GLENNOAK DR
Practice Address - Street 2:
Practice Address - City:BYRAM
Practice Address - State:MS
Practice Address - Zip Code:39272-9384
Practice Address - Country:US
Practice Address - Phone:601-613-6268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03508069Medicaid