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General NPI Number Information
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NPI Number | 1770397903
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Entity Type | Organization
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Legal Business Name | GREENWOOD COUNSELING CENTER TN, PLLC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 130 IMPERIAL BLVD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3440
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Country | US
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Telephone | 704-360-3641
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Fax |
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Provider Business Mailing Address
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Address Line | 108 DALE AVE
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3849
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Country | US
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Telephone | 704-682-0384
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACKIE KURTZ
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Credential |
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Telephone | 704-682-0384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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