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General NPI Number Information
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NPI Number | 1760113286
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 06/24/2022
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Provider Practice Location Address
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Address Line | 3085 BROAD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37408-3084
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Country | US
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Telephone | 423-417-3161
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Fax |
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Provider Business Mailing Address
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Address Line | 3555 KEITH ST NW STE 104
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City | CLEVELAND
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State | TN
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Zip | 37312-4375
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIEA ZELLO
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Credential |
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Telephone | 423-417-3161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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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