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NPI Code Detail

MEDICARE: PSYCHOLOGICAL & COUNSELING SERVICES

MEDICARE: PSYCHOLOGICAL & COUNSELING SERVICES
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
1251S00000XCommunity/Behavioral Health AgencyL 214-107-2118TN

General Provider Information

NPI Number : 1548430333
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHOLOGICAL & COUNSELING SERVICES
Provider Business Mailing Address
First Line : 601 CHARLES ST
Second Line :
City : MARYVILLE
State : TN
Zip : 37804-5048
Country : US
Telephone Number : 865-977-7593
Fax Number : 865-977-7598
Provider Business Practice Location Address
First Line : 601 CHARLES ST
Second Line :
City : MARYVILLE
State : TN
Zip : 37804-5048
Country : US
Telephone Number : 865-977-7593
Fax Number : 865-977-7598
Authorized Official
Title or Position : OWNER/PROVIDER
Name : MS. KARAN E GOINS
Credential : LCSW
Telephone Number : 865-977-7593
Provider Enumeration Date : 03/07/2008
Last Update Date : 09/01/2009

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Directions to “PSYCHOLOGICAL & COUNSELING SERVICES ” Practice Location

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