Provider Demographics
NPI:1790432342
Name:KEMP, DELLA RENICE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DELLA
Middle Name:RENICE
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 1:1207 ROCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-3543
Mailing Address - Country:US
Mailing Address - Phone:601-665-5257
Mailing Address - Fax:
Practice Address - Street 1:1207 ROCKINGHAM DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-3543
Practice Address - Country:US
Practice Address - Phone:601-665-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health