Provider Demographics
NPI:1144533340
Name:PILLOW, JANIE PARKS (MAMFT; MSLPC;MDIV)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:PARKS
Last Name:PILLOW
Suffix:
Gender:F
Credentials:MAMFT; MSLPC;MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 AVIGNON DR
Mailing Address - Street 2:STE 4
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-5166
Mailing Address - Country:US
Mailing Address - Phone:601-853-4788
Mailing Address - Fax:601-853-4788
Practice Address - Street 1:720 AVIGNON DR
Practice Address - Street 2:STE 4
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-5166
Practice Address - Country:US
Practice Address - Phone:601-853-4788
Practice Address - Fax:601-853-4788
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMS0416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional