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NPI Code Detail

MEDICARE: FAITH-CENTERED CHRISTIAN COUNSELING

MEDICARE: FAITH-CENTERED CHRISTIAN COUNSELING
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1659209880
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAITH-CENTERED CHRISTIAN COUNSELING
Provider Business Mailing Address
First Line : 2200 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3874
Country : US
Telephone Number : 423-599-9347
Fax Number :
Provider Business Practice Location Address
First Line : 2200 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3874
Country : US
Telephone Number : 423-599-9347
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : DR. JENNIFER D WALKER
Credential : PA-C
Telephone Number : 615-521-3441
Provider Enumeration Date : 05/09/2026
Last Update Date : 05/09/2026

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1003577370 — ANDREW WILLIAM DIPASTENA MFT TEMP LICENSE
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Directions to “FAITH-CENTERED CHRISTIAN COUNSELING ” Practice Location

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