1558802215 NPI number — TRI-SIGHT COUNSELING SERVICES

Table of content: (NPI 1558802215)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558802215 NPI number — TRI-SIGHT COUNSELING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRI-SIGHT COUNSELING SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LORITA HARRIS DBA TRI-SIGHT COUNSELING SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558802215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1268 MEMORIAL DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38732-9545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-719-1202
Provider Business Mailing Address Fax Number:
662-590-7605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
214 ELM AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUND BAYOU
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38762-5502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-404-8840
Provider Business Practice Location Address Fax Number:
662-590-7605
Provider Enumeration Date:
03/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
LORITA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER/PRACTITIONER
Authorized Official Telephone Number:
662-719-1202

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  1159 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 1159 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 1159 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YS0200X , with the licence number: 166276 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com