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Mr. James W Fendalson, MDIV,CPT,LCMHT
Mental Health Counselor in Gulfport, Mississippi
NPI 1922012012

James W Fendalson is a Mental Health Counselor based in Gulfport, MS and is specialized in Mental Health. James W Fendalson practices in Gulfport, MS and has the professional credentials of MDIV,CPT,LCMHT. The NPI Number for James W Fendalson is 1922012012 and holds a License No. (Mississippi).

The current practice location address for James W Fendalson is 1600 Broad Ave, Gulfport, MS and can be reached out via phone at 228-863-1132 and via fax at 228-865-1700.

Location: 1600 Broad Ave, Gulfport, MS, 39501-3603
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Provider Profile Details
NPI Number
1922012012
Provider Name
James W Fendalson
Credential
MDIV,CPT,LCMHT
Provider Entity Type
Individual
Gender
Male
Address
1600 Broad Ave, Gulfport, MS, 39501-3603
Phone Number
228-863-1132
Fax Number
228-865-1700
Provider Enumeration Date
07/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00018213 05 MS
institution
Provider Business Practice Location Address Details
Address
1600 Broad Ave
City
State
Zip
39501-3603
Phone Number
228-863-1132
Fax Number
228-865-1700
person
Provider Business Mailing Address Details
Address
1600 Broad Ave
City
State
Zip
39501-3603
Phone Number
228-863-1132
Fax Number
228-865-1700
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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