Individual
THOMAS C PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
423 COLLEGE ST, COLUMBUS, MS 39701-5772
(662) 769-2331
Mailing address
9320 RAILROAD AVE, OLIVE BRANCH, MS 38654-2416
(662) 893-1308
(662) 893-1330
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
2123
MS
Other
Enumeration date
10/14/2015
Last updated
06/30/2023
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