Provider Demographics
NPI:1811565625
Name:MASTERPIECE COUNSELING AND HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:MASTERPIECE COUNSELING AND HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CARISHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-874-6921
Mailing Address - Street 1:6943 OAK FOREST DR STE B
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-1976
Mailing Address - Country:US
Mailing Address - Phone:662-874-6921
Mailing Address - Fax:662-932-2921
Practice Address - Street 1:6943 OAK FOREST DR STE B
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-1976
Practice Address - Country:US
Practice Address - Phone:662-804-9140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty