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Dominique Common
Counselor in Ellisville, Mississippi
NPI 1487382958

Dominique Common is a Counselor based in Hattiesburg, MS. Dominique Common practices in Ellisville, MS. The NPI Number for Dominique Common is 1487382958 and holds a License No. 5506 (Mississippi).

The current practice location address for Dominique Common is 5192 Highway 11 N, Ellisville, MS and can be reached out via phone at 601-649-7921 and via fax at 601-649-7939.

Location: 5192 Highway 11 N, Ellisville, MS, 39404-8679
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487382958
Provider Name
Dominique Common
Credential
Provider Entity Type
Individual
Gender
Female
Address
5192 Highway 11 N, Ellisville, MS, 39404-8679
Phone Number
601-649-7921
Fax Number
601-649-7939
Provider Enumeration Date
08/11/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5192 Highway 11 N
City
Ellisville
State
Mississippi
Zip
39437-5050
Phone Number
601-649-7921
Fax Number
601-649-7939
person
Provider Business Mailing Address Details
Address
5192 Highway 11 N
City
Ellisville
State
Mississippi
Zip
39437-5050
Phone Number
601-649-7921
Fax Number
601-649-7939
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
5506 (Mississippi)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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