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General NPI Number Information
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NPI Number | 1538237987
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Entity Type | Organization
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Legal Business Name | COGNITIVE BEHAVIORAL SPECIALISTS OF THE TRI-CITIES
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Dates
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Enumeration Date | 12/02/2006
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 2758 E CENTER ST
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City | KINGSPORT
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State | TN
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Zip | 37664-2754
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Country | US
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Telephone | 423-245-5608
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Fax | 423-245-5600
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Provider Business Mailing Address
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Address Line | 2758 E CENTER ST
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City | KINGSPORT
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State | TN
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Zip | 37664-2754
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Country | US
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Telephone | 423-245-5608
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Fax | 423-245-5600
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | CHERI ANGLIN
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Credential | LCSW
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Telephone | 423-245-5608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW0000003421
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License Number State | TN
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