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General NPI Number Information
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NPI Number | 1972758472
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Entity Type | Organization
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Legal Business Name | CROSSROADS COUNSELING CENTER LLC
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 1016 DOLLY PARTON PKWY SUITE 9
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3740
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Country | US
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Telephone | 865-286-5637
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Fax | 865-286-5665
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Provider Business Mailing Address
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Address Line | 1016 DOLLY PARTON PKWY SUITE 9
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3740
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Country | US
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Telephone | 865-286-5637
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Fax | 865-286-5665
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. JAMES OLIVER BROWN
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Credential | LPC
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Telephone | 865-286-5637
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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 | 2406
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License Number State | TN
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