Organization
LIFEWORKS COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROANE THERELL HUNTER SR. LPC (COUNSELOR/ FAMILY THERAPIST)
(601) 790-0583
Entity
Organization
Contact information
Practice address
940 EBENEZER BLVD., MADISON, MS 39110
(601) 790-0583
Mailing address
818 BEAUMONT DR, MADISON, MS 39110-7310
(601) 790-0583
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1830
MS
251S00000X
Community/Behavioral Health Agency
Primary
1897
MS
Other
Enumeration date
07/21/2016
Last updated
09/27/2016
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