Provider Demographics
NPI:1083437958
Name:DELTA COMPASSIONATE CARE COUNSELING
Entity type:Organization
Organization Name:DELTA COMPASSIONATE CARE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANSOM JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:662-645-7940
Mailing Address - Street 1:1316 BRENTWOOD CV
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-4602
Mailing Address - Country:US
Mailing Address - Phone:662-645-7940
Mailing Address - Fax:
Practice Address - Street 1:1316 BRENTWOOD CV
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-4602
Practice Address - Country:US
Practice Address - Phone:662-645-7940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DELTA COMPASSIONATE CARE COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-07
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health