Provider Demographics
NPI:1982905782
Name:PARSONS-WELLS, JACOB N (LMFT)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:N
Last Name:PARSONS-WELLS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E BROADWAY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-5709
Mailing Address - Country:US
Mailing Address - Phone:865-238-5358
Mailing Address - Fax:
Practice Address - Street 1:200 E BROADWAY AVE STE 200
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5709
Practice Address - Country:US
Practice Address - Phone:865-238-5358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1862106H00000X
SC4615106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist