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Organization

CHRISTIAN COUNSELING CENTER OF BARTLETT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH B. FUSSELL LPC-MHSP; LMFT (OWNER/THERAPIST)
(901) 382-3888
Entity
Organization

Contact information

Practice address
6385 STAGE ROAD, SUITE 1, BARTLETT, TN 38134
(901) 382-3888
(901) 305-6902
Mailing address
6385 STAGE ROAD, SUITE 1, BARTLETT, TN 38134
(901) 382-3888
(901) 305-6902

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
251S00000X
Community/Behavioral Health Agency
LMFT - 600
TN
251S00000X
Community/Behavioral Health Agency
Primary
LPC - 457
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1962636712
INDIVIDUAL NPI
TN
Enumeration date
06/28/2011
Last updated
05/22/2025
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