Organization
WATERSHED COUNSELING ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL SCHULTE MAMFT, LPC, CSAS (CO OWNER, LPC)
(601) 842-4385
Entity
Organization
Contact information
Practice address
1635 LELIA DR STE 203, JACKSON, MS 39216-4874
(601) 362-7020
Mailing address
1635 LELIA DR STE 203, JACKSON, MS 39216-4874
(601) 362-7020
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1207
MS
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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