Organization
MISSISSIPPI BEHAVIOR SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VARGAS L CLARK BCBA (CEO)
(901) 216-1486
Entity
Organization
Contact information
Practice address
5847 GETWELL RD STE 4, SOUTHAVEN, MS 38672-6816
(662) 470-6160
Mailing address
562 OLE DAN RD, SOUTHAVEN, MS 38672-6200
(901) 216-1486
(662) 470-4034
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
Other
Enumeration date
06/24/2015
Last updated
02/15/2024
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