Healthcare Provider Details

I. General information

NPI: 1982438719
Provider Name (Legal Business Name): OFFER A HAND UP COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3427 SHAGBARK CIR
CLARKSVILLE TN
37043-3829
US

IV. Provider business mailing address

3427 SHAGBARK CIR
CLARKSVILLE TN
37043-3829
US

V. Phone/Fax

Practice location:
  • Phone: 317-883-7573
  • Fax: 888-429-1209
Mailing address:
  • Phone: 317-883-7573
  • Fax: 888-429-1209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHANELLE L LAWSON
Title or Position: EXECUTIVE ADMINISTRATOR
Credential:
Phone: 317-883-7573