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Organization
DELTA THERAPY GROUP, LLC
Active
Organization
DELTA THERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERLON J GREEN LCSW (PROVIDER)
(662) 207-1869
Entity
Organization
Contact information
Practice address
612 SUNFLOWER AVENUE EXT STE 12, INDIANOLA, MS 38751-2333
(662) 452-5072
(662) 452-5072
Mailing address
612 SUNFLOWER AVENUE EXT STE 12, INDIANOLA, MS 38751-2333
(662) 452-5072
(662) 452-5072
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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