Provider Demographics
NPI:1609384924
Name:BLAND, ARDELLE (PHD, LPC-MHSP, NCC)
Entity Type:Individual
Prefix:DR
First Name:ARDELLE
Middle Name:
Last Name:BLAND
Suffix:
Gender:F
Credentials:PHD, LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 INTEGRA PRESERVE CT
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-4520
Mailing Address - Country:US
Mailing Address - Phone:423-497-8743
Mailing Address - Fax:
Practice Address - Street 1:9109 INTEGRA PRESERVE CT
Practice Address - Street 2:228
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363
Practice Address - Country:US
Practice Address - Phone:423-779-6063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC2848101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional