Provider Demographics
NPI:1700040037
Name:MOVING FORWARD COUNSELING CENTER,LLC
Entity type:Organization
Organization Name:MOVING FORWARD COUNSELING CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:KING
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:662-240-4090
Mailing Address - Street 1:501 7TH STREET
Mailing Address - Street 2:SUITE 9
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-4683
Mailing Address - Country:US
Mailing Address - Phone:662-240-4090
Mailing Address - Fax:662-240-9992
Practice Address - Street 1:501 7TH ST N
Practice Address - Street 2:SUITE 9
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-4683
Practice Address - Country:US
Practice Address - Phone:662-240-4090
Practice Address - Fax:662-240-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0363101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty