Provider Demographics
NPI:1841661899
Name:PIERCE, AUTUM (LICSW)
Entity type:Individual
Prefix:MRS
First Name:AUTUM
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15323 HIGHWAY 35 S
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-6843
Mailing Address - Country:US
Mailing Address - Phone:662-934-7168
Mailing Address - Fax:
Practice Address - Street 1:302 S SPRING ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-4853
Practice Address - Country:US
Practice Address - Phone:662-205-0098
Practice Address - Fax:662-495-4079
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94891041C0700X
AL5750C1041C0700X
MSC111321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical