Organization Active NPI

Black Sheep Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tupelo, MS
National Provider Identifier
1891412151
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BLACK SHEEP COUNSELING, LLC
Practice address
302 S Spring St Ste 9
Tupelo, MS 38804-4853
Phone
(662) 523-3315
NPI assigned
Oct 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Brooklyn Michelle Sellers, M.ED., LPC, BC-TMH
Title
Licensed Professional Counselor
Phone
(662) 523-3315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

302 S Spring St Ste 9
Tupelo, MS 38804-4853

Mailing address

642 Allen St
Tupelo, MS 38804-3741
Phone (662) 523-3315

National Provider Directory

National Provider Directory

Locations

302 S Spring St
Ste 9
Tupelo, MS 38804
Phone (662) 523-3315

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1891412151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 ALLEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043741",
            "telephone_number": "662-523-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S SPRING ST STE 9",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388044853",
            "telephone_number": "662-523-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK SHEEP COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "BROOKLYN",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "662-523-3315",
        "authorized_official_credential": "M.ED., LPC, BC-TMH"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.