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FAIR PARK COUNSELING PLLC
NPI 1730661331
Clinic/Center - Rehabilitation, Substance Use Disorder in Tupelo, MS

Active since August 30, 2018
210 E MAIN ST STE 2C, TUPELO, MS 38804(662) 760-0052(662) 495-4080 Get Directions Write a Review

NPPES record last updated: November 7, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 7, 2021, Aug 30, 2018 (2 updates tracked since 2018).

About Fair Park Counseling Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIR PARK COUNSELING PLLC (NPI 1730661331) is a healthcare organization registered as a rehabilitation, substance use disorder in Tupelo, Mississippi and active in the NPI registry since August 2018. The organization lists Kelly W Ferguson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1730661331
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameFAIR PARK COUNSELING PLLC
Location Address210 E MAIN ST STE 2CTupelo, MS 38804-4017
Mailing Address210 E Main St Ste 2cTupelo, MS 38804-4017 · (662) 760-0052
Phone(662) 760-0052
Fax(662) 495-4080
Organization SubpartNo
Authorized OfficialKelly W FergusonCeo · (662) 760-0052
Enumeration DateAugust 30, 2018
Last NPPES UpdateNovember 7, 20212 updates tracked since enumeration
NPPES CertifiedNovember 4, 2021
✔ NPI 1730661331 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
210 E MAIN ST STE 2C, Tupelo, MS 38804
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2190688

Fair Park Counseling PLLC · Tupelo, MS
Expired · Aug 17, 2026
CLIA Number25D2190688
Laboratory TypePractitioner Other
Certificate Effective DateAugust 18, 2024
Certificate Expiration DateAugust 17, 2026
Laboratory DirectorKelly W. Ferguson
Laboratory Phone(662) 760-0052
Laboratory LocationFair Park Counseling PLLC210 E Main St Ste 2C, Tupelo, MS 38804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLEE BRENNA STRICKLAND M.ED
Counselor (Mental Health)
210 E MAIN ST STE 2C
TUPELO, MS 38804
Lee County (662) 255-3483
MYRA J SIMMONS MBA, CHWC, NCC, PLPC
Counselor (Mental Health)
210 E MAIN ST STE 2C
TUPELO, MS 38804
Lee County (662) 760-0052
FPC INTENSIVE OUTPATIENT PROGRAM
Counselor (Addiction (Substance Use Disorder))
210 E MAIN ST STE 2C
TUPELO, MS 38804
Lee County (662) 760-0052
KRISTIN ROSE WHITTEN
Counselor
210 E MAIN ST STE 2C
TUPELO, MS 38804
Lee County (662) 760-0052

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fair Park Counseling PLLC's NPI number?

The NPI number for Fair Park Counseling PLLC is 1730661331. It was assigned to this organization in the NPPES registry on August 30, 2018.

Where is Fair Park Counseling PLLC located?

Fair Park Counseling PLLC is located at 210 E Main St Ste 2C, Tupelo, MS 38804. The listed phone number is (662) 760-0052.

What is Fair Park Counseling PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

What insurance does Fair Park Counseling PLLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee list Fair Park Counseling PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fair Park Counseling PLLC was last updated on November 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.