Provider Demographics
NPI:1932945029
Name:PROMISES COUNSELING
Entity type:Organization
Organization Name:PROMISES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KANDICE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:601-270-0663
Mailing Address - Street 1:7 JO RD
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39437-4503
Mailing Address - Country:US
Mailing Address - Phone:601-270-0663
Mailing Address - Fax:
Practice Address - Street 1:812 HIGHWAY 11 S
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MS
Practice Address - Zip Code:39437-3508
Practice Address - Country:US
Practice Address - Phone:601-643-9815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health