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3441 Milford Dr Thompsons Station TN 37179-1523 | |
| (615) 766-0218 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 3441 Milford Dr, Thompsons Station, Tennessee |
| Authorized Official Name and Position | Harland Clayton Harris (OWNER) |
| Authorized Official Contact | 6157660218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3441 Milford Dr Thompsons Station TN 37179-1523 Ph: (615) 766-0218 | 3441 Milford Dr Thompsons Station TN 37179-1523 Ph: (615) 766-0218 |
| NPI Number | 1790106979 |
|---|---|
| Provider Enumeration Date | 12/14/2013 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Medicare PECOS PAC ID | 5597989533 |
|---|---|
| Medicare Enrollment ID | O20140613002012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790106979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1141 (Tennessee) | Secondary |
| 101YP2500X | Counselor - Professional | 3137 (Tennessee) | Primary |
| Provider Name | Mark S Kryter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376569988 PECOS PAC ID: 5597740043 Enrollment ID: I20040621000417 |
| Provider Name | Nicola J Bone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518138866 PECOS PAC ID: 8729158787 Enrollment ID: I20080602000925 |
| Provider Name | Anne M Little-goss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487779476 PECOS PAC ID: 8426189085 Enrollment ID: I20100625000035 |
| Provider Name | Sarah G Mccray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114174505 PECOS PAC ID: 5193047736 Enrollment ID: I20141209002077 |
| Provider Name | Lindsey L Chandler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750650339 PECOS PAC ID: 1658682398 Enrollment ID: I20150622001277 |
| Provider Name | Kindril L Climer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841759263 PECOS PAC ID: 1456689165 Enrollment ID: I20190820000192 |
| Provider Name | Kaleb Pratt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760039929 PECOS PAC ID: 2961892773 Enrollment ID: I20211210000813 |
| Provider Name | Amanda Domangue Bourg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386758068 PECOS PAC ID: 5193119030 Enrollment ID: I20220218001332 |
Lds Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2738 Wales Ct, Thompsons Station, TN 37179 Phone: 615-599-0395 |