| Kingsport Counseling Associates, Pllc | |
|
1417 Warpath Dr Suite B Kingsport TN 37664-3333 | |
| (423) 408-2601 | |
| (888) 395-1262 |
| Full Name | Kingsport Counseling Associates, Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1417 Warpath Dr, Kingsport, Tennessee |
| Authorized Official Name and Position | L Gordon Brewer (PRESIDENT) |
| Authorized Official Contact | 4234082601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingsport Counseling Associates, Pllc 5337 Heritage Ln Kingsport TN 37664-9504 Ph: (423) 408-2601 | Kingsport Counseling Associates, Pllc 1417 Warpath Dr Suite B Kingsport TN 37664-3333 Ph: (423) 408-2601 |
| NPI Number | 1356766133 |
|---|---|
| Provider Enumeration Date | 03/03/2014 |
| Last Update Date | 03/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356766133 | NPI | - | NPPES |
| 1507171 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 617 (Tennessee) | Primary |
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