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General NPI Number Information
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NPI Number | 1114873213
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Entity Type | Organization
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Legal Business Name | TENNESSEE BEHAVIORAL THERAPY CLEVELAND
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 3740 OCOEE PL NW STE 101
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City | CLEVELAND
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State | TN
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Zip | 37312-5635
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Country | US
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Telephone | 423-805-9888
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Fax | 423-805-9889
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Provider Business Mailing Address
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Address Line | 20 COURTHOUSE SQ
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City | JASPER
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State | TN
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Zip | 37347-3530
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Country | US
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Telephone | 423-805-9888
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Fax | 423-805-9889
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Authorized Official
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Title or Position | CREDENTIALING
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Name | COURTNEY B CANTRELL
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Credential |
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Telephone | 423-464-7512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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