Healthcare Provider Details

I. General information

NPI: 1346992062
Provider Name (Legal Business Name): VIRGINIA M. ANDREWS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 TROTWOOD AVE STE 6
COLUMBIA TN
38401-4750
US

IV. Provider business mailing address

513 RUSHMORE DR
COLUMBIA TN
38401-6124
US

V. Phone/Fax

Practice location:
  • Phone: 931-223-5711
  • Fax:
Mailing address:
  • Phone: 931-223-5711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA ANDREWS
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC/MHSP
Phone: 931-223-5711