Provider Demographics
NPI:1679511349
Name:ZIEGELE, JERALDINE A (LPC/MHSP)
Entity Type:Individual
Prefix:MS
First Name:JERALDINE
Middle Name:A
Last Name:ZIEGELE
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 N MAIN ST
Mailing Address - Street 2:STE 110
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-4578
Mailing Address - Country:US
Mailing Address - Phone:931-707-8500
Mailing Address - Fax:
Practice Address - Street 1:53 N MAIN ST
Practice Address - Street 2:STE 110
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4578
Practice Address - Country:US
Practice Address - Phone:931-707-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC1821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health