Real Life Christian Counseling Center

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1348 Issued in MS

Legal business name

REAL LIFE CHRISTIAN COUNSELING CENTER

Practice address

6855 U S Highway 49
Hattiesburg, MS 39402-7834

Phone

(601) 475-1041

NPI assigned

Sep 12, 2013

Organization subpart

No

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

Authorized official

Name

Shandre Cox, LPC

Title

Program Director

Phone

(601) 880-3879

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1588099220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6855 U S HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027834",
            "telephone_number": "601-475-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6855 U S HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027834",
            "telephone_number": "601-475-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL LIFE CHRISTIAN COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "SHANDRE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "601-880-3879",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michong Rayborn, CRNA
• Erin Jones Rayburn, DMD
• Jonathan H.S. Rayburn, MD
• Raye Medical Management
• Billy Gene Ready Jr., PHD, MA
• Rebecca R Duff, PLLC
• Adhvith Reddivari, DO
• Anjelica Redmond, PCMHT
• Randall Reece, DNP, CRNA
• Dominique Reed Watson, PHARMD

• Professional Counselor in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.