Provider Demographics
NPI:1760780316
Name:KEMP, GINNY WARREN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GINNY
Middle Name:WARREN
Last Name:KEMP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ASHBURY PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MS
Mailing Address - Zip Code:39429-3730
Mailing Address - Country:US
Mailing Address - Phone:601-543-9393
Mailing Address - Fax:
Practice Address - Street 1:1113 HIGHWAY 98 BYP STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-3746
Practice Address - Country:US
Practice Address - Phone:601-543-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0455101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor