Organization
NEW LIGHT COUSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RUSSELL LCSW (OWNER)
(662) 401-6457
Entity
Organization
Contact information
Practice address
302 S SPRING ST STE A, TUPELO, MS 38804-4853
(662) 401-6547
(662) 841-8021
Mailing address
302 S SPRING ST STE A, TUPELO, MS 38804-4853
(662) 401-6547
(662) 841-8021
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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