Provider Demographics
NPI:1770713893
Name:TOOLE, BEN F (LPC/JUNGIAN ANALYST)
Entity type:Individual
Prefix:MR
First Name:BEN
Middle Name:F
Last Name:TOOLE
Suffix:
Gender:M
Credentials:LPC/JUNGIAN ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 COUNTY ROAD 151
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965-5250
Mailing Address - Country:US
Mailing Address - Phone:662-832-2424
Mailing Address - Fax:662-473-3725
Practice Address - Street 1:1285 COUNTY ROAD 151
Practice Address - Street 2:
Practice Address - City:WATER VALLEY
Practice Address - State:MS
Practice Address - Zip Code:38965
Practice Address - Country:US
Practice Address - Phone:662-832-2424
Practice Address - Fax:662-473-3725
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ427102L00000X
MS1179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst