Provider Demographics
NPI:1932336732
Name:ODYSSEY COUNSELING
Entity Type:Organization
Organization Name:ODYSSEY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:615-975-7084
Mailing Address - Street 1:638 W IRIS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3191
Mailing Address - Country:US
Mailing Address - Phone:615-975-7084
Mailing Address - Fax:615-292-4459
Practice Address - Street 1:638 W IRIS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3191
Practice Address - Country:US
Practice Address - Phone:615-975-7084
Practice Address - Fax:615-292-4459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN114956876OtherUNITED BEHAVIORAL HEALTH
TN187217000OtherMAGELLAN BEHAVIORAL HEALTH
TN3695729Medicaid
TN976020OtherUNITED HEALTH CARE
TN11509576OtherCAQH
TN976020OtherUNITED HEALTH CARE