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General NPI Number Information
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NPI Number | 1053895367
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Entity Type | Organization
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Legal Business Name | HAZEL TREE COUNSELING
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 56 CLAYTON ST
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City | ASHEVILLE
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State | NC
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Zip | 28801-2424
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Country | US
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Telephone | 828-907-1392
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Fax |
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Provider Business Mailing Address
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Address Line | 84 MIDDLEMONT AVE
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City | ASHEVILLE
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State | NC
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Zip | 28806-2557
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Country | US
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Telephone | 954-243-9970
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. MARTINE LUNTZ JONES
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Credential | PSY.D.
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Telephone | 954-243-9970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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