Provider Demographics
NPI:1851863542
Name:TRIAD COUNSELING AND WELLNESS CORP
Entity Type:Organization
Organization Name:TRIAD COUNSELING AND WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:LENNIR
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:615-481-2495
Mailing Address - Street 1:1400 N MOUNT JULIET RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-1509
Mailing Address - Country:US
Mailing Address - Phone:615-481-2495
Mailing Address - Fax:
Practice Address - Street 1:1400 N MOUNT JULIET RD STE 204
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-1509
Practice Address - Country:US
Practice Address - Phone:615-481-2495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty