Organization
PSYCAMORE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY LICHTE-MADAKASIRA LPC, LMFT (VICE-PRESIDENT)
(601) 939-5993
Entity
Organization
Contact information
Practice address
7165 GETWELL RD, BUILDING 3, SUITE 1 & 2, SOUTHAVEN, MS 38672-9659
(800) 779-2448
(601) 993-5935
Mailing address
2540 FLOWOOD DR, FLOWOOD, MS 39232-9362
(601) 939-5993
(601) 939-5935
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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