Provider Demographics
NPI:1942843446
Name:TRANQUIL COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:TRANQUIL COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUTAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-342-9696
Mailing Address - Street 1:2098 WOOD LAKE LN
Mailing Address - Street 2:
Mailing Address - City:YOUNG HARRIS
Mailing Address - State:GA
Mailing Address - Zip Code:30582-1620
Mailing Address - Country:US
Mailing Address - Phone:866-466-9734
Mailing Address - Fax:
Practice Address - Street 1:333 BIG SKY DR
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-2243
Practice Address - Country:US
Practice Address - Phone:828-342-9696
Practice Address - Fax:706-946-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC009934OtherLICENSED CLINICAL SOCIAL WORKER
GACSW005851OtherLICENSED CLINICAL SOCIAL WORKER