Miranda Ankeny

Individual provider Active NPI Mental Health Counselor · Tupelo, MS

NPI 1245840180 · NPPES record last updated Aug 5, 2020

Key facts

NPI
1245840180
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
2434 S Eason Blvd
Tupelo, MS 38804-6942
Phone
(662) 640-4595
Fax
(662) 680-6416
NPI assigned
Aug 5, 2020
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

2434 S Eason Blvd
Tupelo, MS 38804-6942

Mailing address

2434 S Eason Blvd
Tupelo, MS 38804-6942
Phone (662) 640-4595

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address amerchant@lifecorehealthgroup.com

Other providers in Tupelo, MS

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

Sources for this page

Verify at the official NPI Registry.