=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609759943
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLUE BRANCH COUNSELING PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2025
-----------------------------------------------------
Last Update Date | 02/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1091 KACIE DR
-----------------------------------------------------
City | PLEASANT VIEW
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37146-3708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-307-1935
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1091 KACIE DR
-----------------------------------------------------
City | PLEASANT VIEW
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37146-3708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-307-1935
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AMBER RAHIM
-----------------------------------------------------
Credential | LPCMHSP
-----------------------------------------------------
Telephone | 270-307-1935
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251T00000X
-----------------------------------------------------
Taxonomy Name | PACE Provider Organization
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------