Individual provider · Type 1 NPI

Madison Polk

Mental Health Counselor · Hattiesburg, MS

NPI number 1225852304 Active

Practice location

814 W Pine St
Hattiesburg, MS 39401-4259

Call (601) 781-1661 Map

Mailing address

5996 U S Highway 49
Hattiesburg, MS 39401-7366

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1225852304

Madison Polk's National Provider Identifier is 1225852304, issued on Nov 14, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Hattiesburg, MS. The record was last updated on Nov 14, 2024.