Healthcare Provider Details

I. General information

NPI: 1215869748
Provider Name (Legal Business Name): DEBRADY COUNSELING & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 ORCHARD RD
SHADY VALLEY TN
37688-5224
US

IV. Provider business mailing address

1791 ORCHARD RD
SHADY VALLEY TN
37688-5224
US

V. Phone/Fax

Practice location:
  • Phone: 423-484-8264
  • Fax:
Mailing address:
  • Phone: 423-484-8264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: DENISE DEBRADY
Title or Position: CEO
Credential: LCSW
Phone: 423-484-8264