Provider Demographics
NPI:1801638895
Name:THERAPEUTIC COACHING TRAINING & CONSULTING LLC
Entity type:Organization
Organization Name:THERAPEUTIC COACHING TRAINING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:912-265-7660
Mailing Address - Street 1:106 SHOPPERS WAY STE 115
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0522
Mailing Address - Country:US
Mailing Address - Phone:912-265-7660
Mailing Address - Fax:912-265-7858
Practice Address - Street 1:106 SHOPPERS WAY STE 115
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-0522
Practice Address - Country:US
Practice Address - Phone:912-265-7660
Practice Address - Fax:912-265-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
11511760OtherCAQH