Provider Demographics
NPI:1326715350
Name:COUNTISS, TERESA DEAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:DEAN
Last Name:COUNTISS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 31569
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930
Mailing Address - Country:US
Mailing Address - Phone:865-212-6600
Mailing Address - Fax:865-313-2114
Practice Address - Street 1:162 MARKET PLACE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-212-6600
Practice Address - Fax:865-313-2114
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional