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General NPI Number Information
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NPI Number | 1518248368
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Entity Type | Organization
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Legal Business Name | TRUTH IN COUNSELING
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 1000 BIRCH LN
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City | PORTLAND
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State | TN
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Zip | 37148-6027
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Country | US
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Telephone | 615-878-4058
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 BIRCH LN
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City | PORTLAND
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State | TN
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Zip | 37148-6027
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Country | US
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Telephone | 615-878-4058
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Fax |
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Authorized Official
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Title or Position | OWNER, COUNSELOR
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Name | JUANITA M KISSELL
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Credential | LPC-MHSP
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Telephone | 615-878-4058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC2686
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License Number State | TN
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