| Covenant Counseling & Consultation Services | |
|
3214 Tazewell Pike Ste 203 Knoxville TN 37918-2578 | |
| (865) 254-6045 | |
| (865) 337-7382 |
| Full Name | Covenant Counseling & Consultation Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3214 Tazewell Pike Ste 203, Knoxville, Tennessee |
| Authorized Official Name and Position | Donna Juanita Mitchell (PRESIDENT/CEO) |
| Authorized Official Contact | 8652546045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Counseling & Consultation Services 3214 Tazewell Pike Ste 203 Knoxville TN 37918-2578 Ph: (865) 254-6045 | Covenant Counseling & Consultation Services 3214 Tazewell Pike Ste 203 Knoxville TN 37918-2578 Ph: (865) 254-6045 |
| NPI Number | 1548670359 |
|---|---|
| Provider Enumeration Date | 05/01/2014 |
| Last Update Date | 11/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548670359 | NPI | - | NPPES |
| 6047941 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC0000001551 (Tennessee) | Primary |
| 104100000X | Social Worker | LSW0000007798 (Tennessee) | Secondary |
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