Provider Demographics
NPI: | 1629896915 |
---|---|
Name: | DREAMS OVER DISTRACTIONS CONSULTING & COUNSELING SERVICES LLC |
Entity type: | Organization |
Organization Name: | DREAMS OVER DISTRACTIONS CONSULTING & COUNSELING SERVICES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANNETTE |
Authorized Official - Middle Name: | C |
Authorized Official - Last Name: | JAMES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 662-401-1712 |
Mailing Address - Street 1: | 1308 MICHAEL CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | TUPELO |
Mailing Address - State: | MS |
Mailing Address - Zip Code: | 38801-6111 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 662-401-1712 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1800 W MAIN ST STE 10 |
Practice Address - Street 2: | |
Practice Address - City: | TUPELO |
Practice Address - State: | MS |
Practice Address - Zip Code: | 38801-3256 |
Practice Address - Country: | US |
Practice Address - Phone: | 662-401-1712 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-09-26 |
Last Update Date: | 2025-06-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |