Laureate' Counseling & Personal Development, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LAUREATE' COUNSELING & PERSONAL DEVELOPMENT, LLC

Practice address

510 George St Ste 214
Jackson, MS 39202-3029

Phone

(769) 216-0815

NPI assigned

Jul 3, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tishounna Knox Sulton, LCSWNPI 1366939100

Title

Owner/Clinical Psychotherapist

Phone

(769) 216-0815

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tishounna Knox Sulton, LCSW Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tishounna Knox Sulton, LCSW

  • Clinical Social Worker
  • Byram, MS
  • NPI 1366939100
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1194387787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 GEORGE ST STE 214",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023029",
            "telephone_number": "769-216-0815",
            "fax_number": "601-510-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 GEORGE ST STE 214",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023029",
            "telephone_number": "769-216-0815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2260 Meagan Dr",
            "address_purpose": "LOCATION",
            "city": "Byram",
            "state": "MS",
            "postal_code": "392725676",
            "country_code": "US",
            "telephone_number": "769-216-0815",
            "fax_number": "601-510-9785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAUREATE' COUNSELING & PERSONAL DEVELOPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "SULTON",
        "authorized_official_first_name": "TISHOUNNA",
        "authorized_official_middle_name": "KNOX",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "769-216-0815",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00259005",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tishounna Knox Sulton, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.