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Organization
PSYCHOLOGICAL CONSULTING SERVICES
Active
Organization
PSYCHOLOGICAL CONSULTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES ALBERT BELLEFANT JR. MA, LMFT (VICE PRESIDENT)
(423) 928-8001
Entity
Organization
Contact information
Practice address
112 E MYRTLE AVE, SUITE 304, JOHNSON CITY, TN 37601
(423) 928-8001
Mailing address
112 E MYRTLE AVE, SUITE 304, JOHNSON CITY, TN 37601
(423) 928-8001
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
651
TN
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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