Provider Demographics
NPI:1932883600
Name:EMOTIONALLY AVAILABLE COUNSELING
Entity Type:Organization
Organization Name:EMOTIONALLY AVAILABLE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIEKA
Authorized Official - Middle Name:EBON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:662-404-1429
Mailing Address - Street 1:1867 AMHURST CV
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-5133
Mailing Address - Country:US
Mailing Address - Phone:901-308-7155
Mailing Address - Fax:
Practice Address - Street 1:8830 CENTRE ST STE 2
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-2609
Practice Address - Country:US
Practice Address - Phone:901-308-7155
Practice Address - Fax:662-528-4745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-13
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health