Provider Demographics
NPI:1548430333
Name:PSYCHOLOGICAL & COUNSELING SERVICES
Entity type:Organization
Organization Name:PSYCHOLOGICAL & COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:865-977-7593
Mailing Address - Street 1:601 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-5048
Mailing Address - Country:US
Mailing Address - Phone:865-977-7593
Mailing Address - Fax:865-977-7598
Practice Address - Street 1:601 CHARLES ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5048
Practice Address - Country:US
Practice Address - Phone:865-977-7593
Practice Address - Fax:865-977-7598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL 214-107-2118251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health