Organization
PSYCAMORE LLC
Active
Organization
PSYCAMORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL ANN WILLIAMS LPC (ADULT CLINICAL MANGER)
(662) 349-2818
Entity
Organization
Contact information
Practice address
7165 GETWELL RD, SOUTHAVEN, MS 38672-9618
(662) 349-2818
Mailing address
7165 GETWELL RD, SOUTHAVEN, MS 38672-9618
(662) 349-2818
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
LPC 1510
MS
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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