Provider Demographics
NPI:1538422951
Name:EVERETT, JOSHUA RYAN (LPC)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:RYAN
Last Name:EVERETT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 W OAK ST STE 401E
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4169
Mailing Address - Country:US
Mailing Address - Phone:601-265-3100
Mailing Address - Fax:
Practice Address - Street 1:409 W OAK ST STE 401E
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4169
Practice Address - Country:US
Practice Address - Phone:601-265-3100
Practice Address - Fax:601-265-3101
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1697101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional