| Ida Mae Boatman-goussios, LPC | |
|
1413 Russell Ave, Jefferson City, TN 37760-2562 | |
| (865) 471-5525 | |
| Not Available |
| Full Name | Ida Mae Boatman-goussios |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1413 Russell Ave, Jefferson City, Tennessee |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346405958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC013160 (Georgia) | Secondary |
| 101YP2500X | Counselor - Professional | 2267 (Tennessee) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ida Mae Boatman-goussios, LPC Po Box 577, Newport, TN 37822-0577 Ph: (423) 613-3300 | Ida Mae Boatman-goussios, LPC 1413 Russell Ave, Jefferson City, TN 37760-2562 Ph: (865) 471-5525 |
Mr. Tanner Colin Yankey, LPC-MHSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 1526 Meadow Spring Dr, Jefferson City, TN 37760 Phone: 865-262-9098 | |
Meghan Lee Griffin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1515 Meadow Spring Dr, Jefferson City, TN 37760 Phone: 865-776-6761 | |
Dr. Mark Allan Heinrich, PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 539 Cliff Lane, Jefferson City, TN 37760 Phone: 865-475-9176 | |
Morgan Ella Daniels, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1515 Meadow Spring Dr, Jefferson City, TN 37760 Phone: 865-776-6761 | |
Dr. William Lafayette Blevins, PHD Counselor Medicare: Not Enrolled in Medicare Practice Location: 1646 Russell Ave, Baker 200, Jefferson City, TN 37760 Phone: 865-471-3274 | |
Erica Denise Powell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1526 Meadow Spring Dr, Jefferson City, TN 37760 Phone: 865-262-9098 Fax: 865-262-9103 |