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General NPI Number Information
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NPI Number | 1588317903
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Entity Type | Organization
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Legal Business Name | ANTOSKOW COUNSELING LLC
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 818 1/2 B SOUTH MAIN ST
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City | COLUMBIA
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State | TN
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Zip | 38401
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Country | US
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Telephone | 615-573-3837
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Fax |
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Provider Business Mailing Address
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Address Line | 3258 MECKLENBURG DR
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City | COLUMBIA
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State | TN
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Zip | 38401-5938
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Country | US
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Telephone | 615-573-3837
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRANDON TIMOTHY ANTOSKOW
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Credential | LPC-MHSP
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Telephone | 615-573-3837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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