Healthcare Provider Details

I. General information

NPI: 1386581254
Provider Name (Legal Business Name): TELOS COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 MEMORIAL BLVD STE C
MURFREESBORO TN
37129-5134
US

IV. Provider business mailing address

2670 MEMORIAL BLVD STE C
MURFREESBORO TN
37129-5134
US

V. Phone/Fax

Practice location:
  • Phone: 615-212-8481
  • Fax:
Mailing address:
  • Phone: 615-212-8481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN MOORE
Title or Position: EXECUTIVE DIRECTOR
Credential: LMFT
Phone: 615-212-8481