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General NPI Number Information
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NPI Number | 1639571409
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Entity Type | Organization
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Legal Business Name | CROSSVILLE COUNSELING CENTER, P.C.
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | 1299 GENESIS RD STE 3
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City | CROSSVILLE
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State | TN
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Zip | 38555-5693
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Country | US
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Telephone | 931-456-8600
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Fax | 931-456-8607
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Provider Business Mailing Address
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Address Line | 1299 GENESIS RD STE 3
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City | CROSSVILLE
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State | TN
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Zip | 38555-5693
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Country | US
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Telephone | 931-456-8600
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Fax | 931-456-8607
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DR. DENISE JOY WEAVER
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Credential | L.C.S.W., PH.D.
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Telephone | 931-456-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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