Provider Demographics
NPI:1063735033
Name:PIERCY, JOSEPH BEN (NCC, LPC, LMHC, CADC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BEN
Last Name:PIERCY
Suffix:
Gender:M
Credentials:NCC, LPC, LMHC, CADC
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:PIERCY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LPC, LMHC, CADC
Mailing Address - Street 1:4611 JONATHAN DRIVE
Mailing Address - Street 2:PSYCHOLOGICAL EDUCATION INCORPORATED
Mailing Address - City:HORN LAKE
Mailing Address - State:MS
Mailing Address - Zip Code:38637-5392
Mailing Address - Country:US
Mailing Address - Phone:302-222-7235
Mailing Address - Fax:
Practice Address - Street 1:4611 JONATHAN DRIVE
Practice Address - Street 2:PSYCHOLOGICAL EDUCATION INCORPORATED
Practice Address - City:HORN LAKE
Practice Address - State:MS
Practice Address - Zip Code:38637-5392
Practice Address - Country:US
Practice Address - Phone:302-222-7235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSADO8R-019P101YA0400X
FLMH-5221101YM0800X
MSPC-2072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1214764OtherMS SECRETARY OF STATE BUSINESS ID