Healthcare Provider Details

I. General information

NPI: 1851344840
Provider Name (Legal Business Name): NOVA COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 WEST BLYTHE ST SUITE 2
PARIS TN
38242-3423
US

IV. Provider business mailing address

204 WEST BLYTHE ST SUITE 2
PARIS TN
38242-3423
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-9026
  • Fax: 731-642-1838
Mailing address:
  • Phone: 731-642-9026
  • Fax: 731-642-1838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY F BRASWE
Title or Position: OFFICE MANAGER
Credential:
Phone: 731-642-9026