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Organization
CHANGE YOUR WORLD MENTAL HEALTH AGENCY
Active
Organization
CHANGE YOUR WORLD MENTAL HEALTH AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY DANIELS (OWNER)
(601) 316-6163
Entity
Organization
Contact information
Practice address
4807 N STATE ST STE 401, JACKSON, MS 39206-4826
(601) 316-6163
Mailing address
4807 N STATE ST STE 401, JACKSON, MS 39206-4826
(601) 316-6163
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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