| Tri-star Counseling, Llc | |
|
208 Ferrell Ave Kingsport TN 37663-2336 | |
| (423) 426-6901 | |
| Not Available |
| Full Name | Tri-star Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 208 Ferrell Ave, Kingsport, Tennessee |
| Authorized Official Name and Position | Brent Metcalf (THERAPIST) |
| Authorized Official Contact | 4234266901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-star Counseling, Llc 208 Ferrell Ave Kingsport TN 37663-2336 Ph: (423) 426-6901 | Tri-star Counseling, Llc 208 Ferrell Ave Kingsport TN 37663-2336 Ph: (423) 426-6901 |
| NPI Number | 1184376741 |
|---|---|
| Provider Enumeration Date | 01/24/2022 |
| Last Update Date | 01/24/2022 |
| Certification Date | 01/24/2022 |
| Medicare PECOS PAC ID | 4486049384 |
|---|---|
| Medicare Enrollment ID | O20220310002898 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184376741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brent Metcalf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306490024 PECOS PAC ID: 5395130298 Enrollment ID: I20220310002907 |
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