Provider Demographics
NPI:1942752043
Name:JESSICA M BASKETT
Entity Type:Organization
Organization Name:JESSICA M BASKETT
Other - Org Name:ARROW COUNSELING SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BASKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-295-6131
Mailing Address - Street 1:1520 29TH AVE
Mailing Address - Street 2:SUITE 19
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2843
Mailing Address - Country:US
Mailing Address - Phone:662-295-6131
Mailing Address - Fax:
Practice Address - Street 1:1520 29TH AVE
Practice Address - Street 2:SUITE 19
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2843
Practice Address - Country:US
Practice Address - Phone:662-295-6131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty