Restore Counseling and Consulting Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

RESTORE COUNSELING AND CONSULTING SERVICES

Practice address

4500 I 55 N Ste 223
Jackson, MS 39211-5931

Phone

(601) 214-7464

Fax

(601) 398-9493

NPI assigned

Aug 18, 2016

Last updated

Nov 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shandra Wilson, LPCNPI 1285043968

Title

Owner

Phone

(601) 214-7464

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shandra Wilson, LPC

  • Professional Counselor
  • Jackson, MS
  • NPI 1285043968
  NPD Authorized official

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1912452095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 I 55 N STE 220",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115931",
            "telephone_number": "601-214-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 I 55 N STE 223",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115931",
            "telephone_number": "601-214-7464",
            "fax_number": "601-398-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE COUNSELING AND CONSULTING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-214-7464",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.