Provider Demographics
NPI:1871924787
Name:JACKSON-CALHOUN COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:JACKSON-CALHOUN COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KIRKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-323-0543
Mailing Address - Street 1:2860 HIGHWAY 71
Mailing Address - Street 2:SUITE A
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-1867
Mailing Address - Country:US
Mailing Address - Phone:850-482-0019
Mailing Address - Fax:850-482-0015
Practice Address - Street 1:2860 HIGHWAY 71
Practice Address - Street 2:SUITE A
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-1867
Practice Address - Country:US
Practice Address - Phone:850-482-0019
Practice Address - Fax:850-482-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health