Sandra F Black, LCSAC

Individual provider Active NPI Mental Health Counselor · Ackerman, MS

NPI 1174765481 · NPPES record last updated Jun 7, 2010

Key facts

NPI
1174765481
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
100 Old Sturgis Rd
Ackerman, MS 39735-6600
Phone
(662) 285-6225
Fax
(662) 285-6226
NPI assigned
Apr 1, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

100 Old Sturgis Rd
Ackerman, MS 39735-6600

Mailing address

302 N Jackson St
P O Box 1188
Starkville, MS 39759-2504
Phone (662) 323-9261

Other providers in Ackerman, MS

All providers in Ackerman, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.