Organization
PEACE OF MIND THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN L HARTSELL LCSW (THERAPIST)
(423) 444-3677
Entity
Organization
Contact information
Practice address
207 BOONE ST, SUITE 27, JOHNSON CITY, TN 37604-5603
(423) 444-3677
(423) 244-0602
Mailing address
207 BOONE ST, SUITE 27, JOHNSON CITY, TN 37604-5603
(423) 444-3677
(423) 244-0602
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
4902
TN
1041C0700X
Clinical Social Worker
Primary
5391
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I802362
MEDICARE PTAN
—
Enumeration date
06/26/2012
Last updated
06/26/2012
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