Provider Demographics
NPI:1285935932
Name:SUMMIT COUNSELING
Entity type:Organization
Organization Name:SUMMIT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:MUMBOWER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:601-949-1949
Mailing Address - Street 1:431 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39201-1108
Mailing Address - Country:US
Mailing Address - Phone:601-949-1949
Mailing Address - Fax:601-714-6922
Practice Address - Street 1:431 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39201-1108
Practice Address - Country:US
Practice Address - Phone:601-949-1949
Practice Address - Fax:601-714-6922
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST BAPTIST CHRUCH JACKSON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty