Provider Demographics
NPI:1518448554
Name:BANDEL COUNSELING SERVICE
Entity Type:Organization
Organization Name:BANDEL COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:931-217-8797
Mailing Address - Street 1:3592 RABBIT RUN TRL
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:TN
Mailing Address - Zip Code:37010-8012
Mailing Address - Country:US
Mailing Address - Phone:931-217-8797
Mailing Address - Fax:
Practice Address - Street 1:113 3RD ST.
Practice Address - Street 2:SUITE 25
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040
Practice Address - Country:US
Practice Address - Phone:931-217-8797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6766261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health