MEDICARE: MR. JERELL ARMSTRONG MA, LPC

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
1	101YP2500X	Professional Counselor	6658	TN

General Provider Information

NPI Number	:	1346066057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JERELL ARMSTRONG MA, LPC

Provider Business Mailing Address
First Line	:	5805 LEE HWY STE 107
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-3546
Country	:	US
Telephone Number	:	423-380-1259
Fax Number	:	800-701-6250

Provider Business Practice Location Address
First Line	:	5805 LEE HWY STE 107
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-3546
Country	:	US
Telephone Number	:	423-380-1259
Fax Number	:	800-701-6250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2024
Last Update Date	:	11/26/2024

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