Provider Demographics
NPI:1477233369
Name:COURAGEOUS PEOPLE THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:COURAGEOUS PEOPLE THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:615-609-2444
Mailing Address - Street 1:479 W SAM RIDLEY PKWY
Mailing Address - Street 2:STE 105 PMB 332
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6493
Mailing Address - Country:US
Mailing Address - Phone:615-609-2444
Mailing Address - Fax:
Practice Address - Street 1:225 BRIARCOTES CIR
Practice Address - Street 2:
Practice Address - City:LA VERGNE
Practice Address - State:TN
Practice Address - Zip Code:37086-3839
Practice Address - Country:US
Practice Address - Phone:615-609-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty