Provider Demographics
NPI:1023903341
Name:CHAMBLISS COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:CHAMBLISS COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBLISS
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, LPC , NCC
Authorized Official - Phone:601-748-4214
Mailing Address - Street 1:2076 GRAVEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:MS
Mailing Address - Zip Code:39069-5057
Mailing Address - Country:US
Mailing Address - Phone:601-809-6968
Mailing Address - Fax:601-610-7147
Practice Address - Street 1:2076 GRAVEL HILL RD
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:MS
Practice Address - Zip Code:39069-5057
Practice Address - Country:US
Practice Address - Phone:601-809-6968
Practice Address - Fax:601-610-7147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health