Provider Demographics
NPI:1851821623
Name:PRACTICAL SOLUTIONS COUNSELING & CONSULTING, PLLC
Entity Type:Organization
Organization Name:PRACTICAL SOLUTIONS COUNSELING & CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:VAN CHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:228-314-3626
Mailing Address - Street 1:15520 DANIEL BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4744
Mailing Address - Country:US
Mailing Address - Phone:228-314-3626
Mailing Address - Fax:
Practice Address - Street 1:2059 E PASS RD STE 4
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3761
Practice Address - Country:US
Practice Address - Phone:228-314-3626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01378584Medicaid