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Organization
COMPASSIONATE HEARTS
Active
Organization
COMPASSIONATE HEARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIRA JOHNSON LCSW (CLINICAL SERVICE DIRECTOR)
(769) 233-8585
Entity
Organization
Contact information
Practice address
1828 RAYMOND RD, SUITE A, JACKSON, MS 39204-4126
(769) 233-8585
(877) 907-6577
Mailing address
1828 RAYMOND RD, SUITE A, JACKSON, MS 39204-4126
(769) 233-8585
(877) 907-6577
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6696
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06202806
—
MS
Enumeration date
08/10/2012
Last updated
06/22/2015
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