Organization
PHOENIX BEHAVIORAL HEALTH CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN KIM WAGGONER PSYD, ABPP (CEO)
(228) 819-2171
Entity
Organization
Contact information
Practice address
2112 BIENVILLE BLVD STE K, OCEAN SPRINGS, MS 39564-3067
(228) 819-2171
(228) 205-4986
Mailing address
2112 BIENVILLE BLVD STE K, OCEAN SPRINGS, MS 39564-3067
(228) 819-2171
(833) 779-1879
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TH0004X
Health Psychologist
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
06/10/2024
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