Healthcare Provider Details

I. General information

NPI: 1295908416
Provider Name (Legal Business Name): RESOLUTION THERAPY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 W MAIN ST STE. B
LEBANON TN
37087-2744
US

IV. Provider business mailing address

228 W MAIN ST STE. B
LEBANON TN
37087-2744
US

V. Phone/Fax

Practice location:
  • Phone: 615-414-8249
  • Fax:
Mailing address:
  • Phone: 615-414-8249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2655
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4196
License Number StateTN

VIII. Authorized Official

Name: DR. CHRISTINA S JONES
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 615-414-8249