| Summit Counseling Center, Llc | |
|
6400 Lee Hwy Ste 106 Chattanooga TN 37421-2452 | |
| (423) 855-0402 | |
| (423) 370-1518 |
| Full Name | Summit Counseling Center, Llc |
|---|---|
| Speciality | Counselor |
| Location | 6400 Lee Hwy Ste 106, Chattanooga, Tennessee |
| Authorized Official Name and Position | Goff Owen (PRACTICE MANAGER) |
| Authorized Official Contact | 4238550402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Counseling Center, Llc 6400 Lee Hwy Ste 106 Chattanooga TN 37421-2452 Ph: (423) 855-0402 | Summit Counseling Center, Llc 6400 Lee Hwy Ste 106 Chattanooga TN 37421-2452 Ph: (423) 855-0402 |
| NPI Number | 1578951026 |
|---|---|
| Provider Enumeration Date | 01/07/2015 |
| Last Update Date | 06/20/2016 |
| Medicare PECOS PAC ID | 6406121680 |
|---|---|
| Medicare Enrollment ID | O20171014000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578951026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Timothy A Sisemore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821074832 PECOS PAC ID: 2062599129 Enrollment ID: I20080414000563 |
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