Provider Demographics
NPI:1649769175
Name:OUT OF THE WOODS THERAPEUTIC COUNSELING, PLLC
Entity Type:Organization
Organization Name:OUT OF THE WOODS THERAPEUTIC COUNSELING, PLLC
Other - Org Name:OUT OF THE WOODS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:ZANE
Authorized Official - Last Name:BRAZELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMFT, CST
Authorized Official - Phone:828-333-4907
Mailing Address - Street 1:19 ZILLICOA ST STE 3
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1063
Mailing Address - Country:US
Mailing Address - Phone:828-333-4907
Mailing Address - Fax:828-412-3257
Practice Address - Street 1:19 ZILLICOA ST STE 3
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1063
Practice Address - Country:US
Practice Address - Phone:828-333-4907
Practice Address - Fax:828-412-3257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty