# PSYCHOLOGICAL CONSULTING SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568644854
- **Authorized official:** MR. CHARLES ALBERT BELLEFANT JR. MA, LMFT (VICE PRESIDENT)
- **Authorized official phone:** (423) 928-8001

## Contact information

- **Practice address:** 112 E MYRTLE AVE, SUITE 304, JOHNSON CITY, TN 37601
- **Practice address phone:** (423) 928-8001
- **Mailing address:** 112 E MYRTLE AVE, SUITE 304, JOHNSON CITY, TN 37601
- **Mailing address phone:** (423) 928-8001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 651 | TN | Yes |

## Other

- **Enumeration date:** 11/29/2007
- **Last updated:** 11/29/2007