Basic Information
| Provider Information | |||||||||
| NPI: | 1558802215 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRI-SIGHT EDUCATIONAL COUNSELING & CONSULTING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1268 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 387329545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6627191202 | ||||||||
| FaxNumber: | 6627543304 | ||||||||
| Practice Location | |||||||||
| Address1: | 1268 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 387329545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6627191202 | ||||||||
| FaxNumber: | 6627543304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2017 | ||||||||
| LastUpdateDate: | 03/15/2017 | ||||||||
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| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | LORITA | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO, LPC | ||||||||
| AuthorizedOfficialTelephone: | 6627191202 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | LPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 1159 | MS | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | 101YP2500X | 1159 | MS | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 101YS0200X | 166276 | MS | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | School | 101YM0800X | 1159 | MS | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.