MEDICARE: MR. ANDRE L JAMES 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	7483	TN

General Provider Information

NPI Number	:	1508342221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDRE L JAMES LPC

Provider Business Mailing Address
First Line	:	755 BROAD ST NW STE B
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-2248
Country	:	US
Telephone Number	:	423-641-1211
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 BROAD ST NW STE B
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-2248
Country	:	US
Telephone Number	:	423-641-1211
Fax Number	:

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

Provider Enumeration Date	:	07/16/2018
Last Update Date	:	04/18/2025

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Directions to “ MR. ANDRE L JAMES LPC” Practice Location

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