Provider Demographics
NPI:1215756101
Name:PATIENTLY DISCOVERING PEACE LLC
Entity type:Organization
Organization Name:PATIENTLY DISCOVERING PEACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LPC
Authorized Official - Prefix:
Authorized Official - First Name:DEANDRA
Authorized Official - Middle Name:MILAM
Authorized Official - Last Name:CALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-230-4305
Mailing Address - Street 1:6332 SANDBOURNE W
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6562
Mailing Address - Country:US
Mailing Address - Phone:901-230-4305
Mailing Address - Fax:
Practice Address - Street 1:6332 SANDBOURNE W
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-6562
Practice Address - Country:US
Practice Address - Phone:901-230-4305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)