# PENDLETON COUNSELING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pendleton Counseling Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548869712
- **Authorized official:** DR. LINDA FAYE PENDLETON (LICENSED CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (601) 201-4111

## Contact information

- **Practice address:** 403 OLD TOWN CIR, BRANDON, MS 39042-3628
- **Practice address phone:** (601) 201-4111
- **Practice address fax:** (601) 825-1793
- **Mailing address:** 403 OLD TOWN CIR, BRANDON, MS 39042-3628
- **Mailing address phone:** (601) 201-4111
- **Mailing address fax:** (601) 825-1793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 10/20/2020
- **Last updated:** 10/20/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 06635891 | — | MS |