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NPI Code Detail

MEDICARE: HENDRICK COUNSELING SERVICES, INC

MEDICARE: HENDRICK COUNSELING SERVICES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TP0016XPrescribing (Medical) PsychologistAPN0000012314TN

General Provider Information

NPI Number : 1215468467
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENDRICK COUNSELING SERVICES, INC
Provider Business Mailing Address
First Line : 440 PARK AVE
Second Line :
City : LEBANON
State : TN
Zip : 37087
Country : US
Telephone Number : 615-449-9611
Fax Number : 615-453-7051
Provider Business Practice Location Address
First Line : 440 PARK AVE
Second Line :
City : LEBANON
State : TN
Zip : 37087-3664
Country : US
Telephone Number : 615-449-9611
Fax Number : 615-453-7051
Authorized Official
Title or Position : OWNER
Name : MRS. KIMBERLEY HENDRICK
Credential : LCSW
Telephone Number : 615-449-9611
Provider Enumeration Date : 03/21/2017
Last Update Date : 03/21/2017

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Practice Location Address:
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Directions to “HENDRICK COUNSELING SERVICES, INC ” Practice Location

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