Provider Demographics
NPI:1972668119
Name:BREAKTHROUGH COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:BREAKTHROUGH COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-355-5997
Mailing Address - Street 1:240 MAYFIELD DR STE 207
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-3026
Mailing Address - Country:US
Mailing Address - Phone:615-355-5997
Mailing Address - Fax:615-355-5497
Practice Address - Street 1:240 MAYFIELD DR STE 207
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3026
Practice Address - Country:US
Practice Address - Phone:615-355-5997
Practice Address - Fax:615-355-5497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000031791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty