Healthcare Provider Details
I. General information
NPI: 1720894397
Provider Name (Legal Business Name): DIMENSIONS COUNSELING CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2024
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
703 MARBORO DR
JOHNSON CITY TN
37601-2432
US
IV. Provider business mailing address
PO BOX 153
PINEY FLATS TN
37686-0153
US
V. Phone/Fax
- Phone: 423-722-2499
- Fax: 423-722-2499
- Phone: 423-722-2499
- Fax: 423-722-2499
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
HUNTER
COOK
Title or Position: OWNER
Credential: MS
Phone: 423-722-2499