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Individual

MR. MARK R VANDERLIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A., LPC/MHSP

Contact information

Practice address
3845 HOLSTON COLLEGE RD., LOUISVILLE, TN 37777-4029
(865) 524-5757
(865) 380-5088
Mailing address
201 WEST SPRINGDALE AVE., KNOXVILLE, TN 37917-5158
(865) 637-9711
(865) 637-9711

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
9726
CO
101YM0800X
Mental Health Counselor
LPC2607
TN
101YP2500X
Professional Counselor
Primary
LPC2607
TN

Other

Enumeration date
12/18/2007
Last updated
11/19/2010
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