Individual
MS. CLAUDIA LILIAN GOSSETT-DIVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC/MHSP.,LADAC
Contact information
Practice address
25 SECURITY DR, JACKSON, TN 38305-3754
(731) 668-1271
(731) 424-4385
Mailing address
550 HARTS BRIDGE RD, JACKSON, TN 38301-9538
(731) 424-4385
(731) 424-4385
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0000000175
TN
101YM0800X
Mental Health Counselor
Primary
0000001758
TN
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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