Fair Park Counseling Pllc
NPI #1730661331 in Tupelo, Mississippi
Provider Information
- NPI Number
- 1730661331
- Entity Type
- Organization
- Organization Name
- Fair Park Counseling Pllc
- Primary Specialty
- Clinic/Center - Rehabilitation, Substance Use Disorder
- Enumeration Date
- Aug 30, 2018
- Last Updated
- Nov 7, 2021
Practice Location
- Address
- 210 E MAIN ST STE 2C
- City
- Tupelo
- State
- Mississippi
- ZIP Code
- 38804-4017
- Phone
- (662) 760-0052
Authorized Official
- Name
- MR. KELLY W FERGUSON, LPC
- Title
- CEO
- Phone
- (662) 760-0052
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Counselor - Mental Health — Mental Health |
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
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