Organization
TT & S FAMILY FOUNDATION INC
Active
Other names
Azaela Trace Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THELMA DEES-JOHNSON (LPC-MHSP)
61591504074
Entity
Organization
Contact information
Practice address
319 PLUS PARK BLVD, NASHVILLE, TN 37217-1098
(615) 915-4074
(615) 942-6342
Mailing address
PO BOX 132, OLD HICKORY, TN 37138-0132
(615) 915-4074
(615) 942-6392
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2111
TN
101YP2500X
Professional Counselor
2111
TN
104100000X
Social Worker
3847
TN
106H00000X
Marriage & Family Therapist
2111
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5442020
—
TN
05
—
H445718
—
TN
Enumeration date
09/16/2011
Last updated
06/04/2013
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