Provider Demographics
NPI:1902392574
Name:DEA DEAN LPC, LLC
Entity Type:Organization
Organization Name:DEA DEAN LPC, LLC
Other - Org Name:COUNSELING COLLECTIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEA
Authorized Official - Middle Name:DIXON
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:769-300-1443
Mailing Address - Street 1:206 W JACKSON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-2310
Mailing Address - Country:US
Mailing Address - Phone:769-300-1443
Mailing Address - Fax:769-208-4477
Practice Address - Street 1:206 W JACKSON ST STE 100
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2310
Practice Address - Country:US
Practice Address - Phone:769-300-1443
Practice Address - Fax:769-208-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-07
Last Update Date:2018-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty