Provider Demographics
NPI:1265858682
Name:TRI-CITIES THERAPY & COUNSELING
Entity type:Organization
Organization Name:TRI-CITIES THERAPY & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:II
Authorized Official - Credentials:LICENSED COUNSELOR
Authorized Official - Phone:423-943-5550
Mailing Address - Street 1:1907 N ROAN ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3164
Mailing Address - Country:US
Mailing Address - Phone:423-943-5550
Mailing Address - Fax:
Practice Address - Street 1:1907 NORTH ROAN STREET
Practice Address - Street 2:SUITE 406
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-943-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94902251H1300X
TN2303101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman FactorsGroup - Multi-Specialty