Organization
TEW COUNSELING LLC
Active
Other names
Revive Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS LAMAR TEW LCSW (OWNER)
(601) 718-0328
Entity
Organization
Contact information
Practice address
4500 I 55 N STE 216, JACKSON, MS 39211-5931
(601) 718-0328
Mailing address
4500 I 55 N STE 216, JACKSON, MS 39211-5931
(601) 718-0328
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6882
MS
Other
Enumeration date
04/14/2018
Last updated
04/14/2018
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