Organization
INNOVATIVE COUNSELING OF MISSISSIPPI, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH MARIE PRADILLO LPC (OWNER)
(601) 708-9558
Entity
Organization
Contact information
Practice address
4780 1-55 N, SUITE 100-103, JACKSON, MS 39211
(601) 708-9558
Mailing address
115 BELLEGROVE BLVD, BRANDON, MS 39047-6625
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
04/04/2023
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