Provider Demographics
NPI:1790106979
Name:CLINICAL & FORENSIC CONSULTATION, LLC
Entity Type:Organization
Organization Name:CLINICAL & FORENSIC CONSULTATION, LLC
Other - Org Name:THRIVEWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARLAND
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/MHSP, AS
Authorized Official - Phone:423-573-6836
Mailing Address - Street 1:1020 N SUGARTREE LN
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-8564
Mailing Address - Country:US
Mailing Address - Phone:423-573-6836
Mailing Address - Fax:423-388-4774
Practice Address - Street 1:100 5TH ST STE 310
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-5919
Practice Address - Country:US
Practice Address - Phone:423-822-5099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-14
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1141101YA0400X
TN3137101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty