Provider Demographics
NPI:1427460302
Name:INTEGRATIVE THERAPEUTIC COUNSELING AND CONSULTANTS
Entity type:Organization
Organization Name:INTEGRATIVE THERAPEUTIC COUNSELING AND CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURR
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:601-750-9909
Mailing Address - Street 1:5935 HIGHWAY 18 W STE C
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39209-9626
Mailing Address - Country:US
Mailing Address - Phone:601-750-9909
Mailing Address - Fax:
Practice Address - Street 1:5935 HIGHWAY 18 W STE C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39209-9626
Practice Address - Country:US
Practice Address - Phone:601-750-9909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty