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General NPI Number Information
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NPI Number | 1053716225
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTER
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 2711 MURFREESBORO PIKE SUITE 100
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City | ANTIOCH
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State | TN
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Zip | 37013-2000
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Country | US
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Telephone | 615-361-0052
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 MURFREESBORO PIKE SUITE 100
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City | ANTIOCH
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State | TN
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Zip | 37013-2000
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Country | US
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Telephone | 615-361-0052
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MR. DAVID ANTHONY RANKIN
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Credential | LPE
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Telephone | 615-361-0052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PE11126
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License Number State | TN
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