Provider Demographics
NPI:1942497169
Name:SALLY KATE WINTERS FAMILY SERVICES
Entity Type:Organization
Organization Name:SALLY KATE WINTERS FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-494-4867
Mailing Address - Street 1:PO BOX 1233
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-1233
Mailing Address - Country:US
Mailing Address - Phone:662-494-4867
Mailing Address - Fax:662-494-0870
Practice Address - Street 1:317 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-2439
Practice Address - Country:US
Practice Address - Phone:662-494-4867
Practice Address - Fax:662-494-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC57871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty