Shaunita Weathersby, CMHT

Individual provider Active NPI Mental Health Counselor · Richton, MS

NPI 1689389397 · NPPES record last updated Jan 17, 2023

Key facts

NPI
1689389397
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
5600 (MS)
Practice address
91180 Highway 42
Richton, MS 39476-9254
Phone
(601) 788-6308
Fax
(601) 788-6349
NPI assigned
Jan 17, 2023
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

State licenses

LicenseStateTypeSpecialty
5600MSMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5600 MS Yes

Addresses

Primary practice location

91180 Highway 42
Richton, MS 39476-9254

Mailing address

PO Box 18679
Hattiesburg, MS 39404-8679
Phone (601) 705-1901

Other providers in Richton, MS

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

Sources for this page

Verify at the official NPI Registry.