Provider Demographics
NPI:1376350926
Name:LIBERATION COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:LIBERATION COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:560-991-5657
Mailing Address - Street 1:706 PINEHURST ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-4040
Mailing Address - Country:US
Mailing Address - Phone:601-991-5697
Mailing Address - Fax:
Practice Address - Street 1:706 PINEHURST ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4040
Practice Address - Country:US
Practice Address - Phone:601-991-5697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty