Individual
MR. BILLY JOE MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NCC LPC
Contact information
Practice address
26 MIDWAY ST, BRISTOL, TN 37620
(423) 989-4500
(423) 989-4582
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC 720
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019
CHAMPUS TRICARE
—
01
—
138373
ANTHEM PROF TRIGON
—
01
—
3085402
MAGELLAN NAVIGATOR
—
01
—
334969
VALUE OPTIONS GROUP
—
Enumeration date
08/13/2006
Last updated
07/08/2007
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