Lyinka Nicole Boston

Individual provider Active NPI Mental Health Counselor · Brandon, MS

NPI 1992472146 · NPPES record last updated Aug 25, 2021

Key facts

NPI
1992472146
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
613 Marquette Rd
Brandon, MS 39042-3038
Phone
(601) 824-1692
NPI assigned
Aug 25, 2021
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

613 Marquette Rd
Brandon, MS 39042-3038

Mailing address

PO Box 88
Brandon, MS 39043-0088
Phone (601) 824-1692

Other providers in Brandon, MS

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

Sources for this page

Verify at the official NPI Registry.