Organization
PRENTISS COUNSELING AND CONSULTING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED PRENTISS LPC-MHSP (OWNER)
(615) 669-5605
Entity
Organization
Contact information
Practice address
5320 HICKORY HOLLOW PKWY, ANTIOCH, TN 37013-3128
(615) 669-5605
Mailing address
1091 SECRETARIAT DR, MOUNT JULIET, TN 37122-3568
(615) 669-5605
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2904
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q014226
—
TN
Enumeration date
04/04/2018
Last updated
04/04/2018
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