Individual
ANTHONY JEROME WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCC, LPC-S
Contact information
Practice address
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671-2603
(662) 772-5937
(662) 772-5940
Mailing address
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671-2603
(662) 772-5937
(662) 772-5940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1326
MS
101YP2500X
Professional Counselor
Primary
1326
MS
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
04/09/2010
Last updated
05/01/2025
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