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General NPI Number Information
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NPI Number | 1730445362
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Entity Type | Organization
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Legal Business Name | RATIONAL TRAINING AND COUNSELING ASSOCIATS
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 4525 HARDING PIKE STE 200
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City | NASHVILLE
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State | TN
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Zip | 37205-2154
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Country | US
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Telephone | 615-823-3955
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Fax |
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Provider Business Mailing Address
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Address Line | P.O BOX 564
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City | ANTIOCH
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State | TN
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Zip | 37011
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Country | US
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Telephone | 616-308-1162
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. CLYDE A POAG
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Credential | LCSW
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Telephone | 616-308-1162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5618
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License Number State | TN
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