Provider Demographics
NPI:1831382365
Name:ELBOW TREE CHRISTIAN COUNSELING, LLC
Entity type:Organization
Organization Name:ELBOW TREE CHRISTIAN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCILVAINE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:423-517-7070
Mailing Address - Street 1:3069 BROAD ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-3047
Mailing Address - Country:US
Mailing Address - Phone:423-517-7070
Mailing Address - Fax:423-894-9275
Practice Address - Street 1:3069 BROAD ST
Practice Address - Street 2:SUITE 6
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-3047
Practice Address - Country:US
Practice Address - Phone:423-517-7070
Practice Address - Fax:423-894-9275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN560101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty