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General NPI Number Information
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NPI Number | 1417255720
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Entity Type | Organization
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Legal Business Name | CONFIDENTIAL COUNSELING SOLUTIONS LLC
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 2102 FOREST DR SUITE 5
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City | GRAY
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State | TN
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Zip | 37615-3493
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Country | US
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Telephone | 423-895-4053
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Fax | 706-364-4340
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Provider Business Mailing Address
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Address Line | 2111 FOTHERGILL DR
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City | EVANS
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State | GA
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Zip | 30809-7242
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Country | US
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Telephone | 423-895-4053
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Fax | 706-364-4340
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANNE LEWIS-NASH
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Credential | LCSW
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Telephone | 423-895-4053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW0000005264
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License Number State | TN
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