=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184787798
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABBY LESOWITZ EIBEL M.A.ED
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2006
-----------------------------------------------------
Last Update Date | 01/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 441 E BROAD ST SUITE H
-----------------------------------------------------
City | COOKEVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38501-3389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-520-4309
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 661
-----------------------------------------------------
City | MONTEREY
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38574-0661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-260-0477
-----------------------------------------------------
Fax | 931-600-3165
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPC0000001727
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------