Organization
EPIPHANY COUNSELING CENTER LLC
Active
Other names
Epiphany Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHEDRA MONIQUE JOHNSON LCSW (LICENSED CERTIFIED SOCIAL WORKER)
(228) 918-9788
Entity
Organization
Contact information
Practice address
368 COURTHOUSE RD, GULFPORT, MS 39507-1856
(228) 918-9788
Mailing address
368 COURTHOUSE RD, GULFPORT, MS 39507-1856
(228) 918-9788
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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