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LIFELINE CENTER PLLC NPI 1154509958


NPI Information

NPI: 1154509958
Provider Name: LIFELINE CENTER, PLLC

Doing Business As: LIFELINE COUNSELING CENTER

Classification: Psychologist - 103TH0100X
Entity Type: Organization

Specialization: Health Service

Address:
294 GAMBLE AVE
MARYVILLE, TN
ZIP 37801
Phone: (865) 981-7400
Get Directions

LIFELINE CENTER, PLLC is a health service psychologist in Maryville, TN. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). LIFELINE CENTER, PLLC NPI is 1154509958. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lifeline Counseling Center.

The provider's business location address is:

294 GAMBLE AVE
MARYVILLE, TN
ZIP 37801-943
Phone: (865) 981-7400

The provider's authorized official is Nancy Joy Carroll .
The authorized official title is Executive Director/psychologist and has the following contact phone number (865) 981-7400.

The enumeration date for this NPI number is 2/4/2008 and was last updated on 2/26/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical4684TENNESSEENo
2101YP2500XCounselorProfessional686TENNESSEENo
31041C0700XSocial WorkerClinical3876TENNESSEENo
4103TH0100XPsychologistHealth Service1002TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1103G705020MEDICARE PINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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