Individual
MR. TIM A PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC MHSP MA
Contact information
Practice address
26 MIDWAY ST, BRISTOL REGIONAL COUNSELING CENTER, BRISTOL, TN 37620
(423) 989-4500
(423) 989-4568
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC1447
TN
101YP2500X
Professional Counselor
Primary
1447
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010149371
VIRGINIA MEDICAID JOHNSON
—
01
—
010149380
VIRGINIA MEDICAID BRCC
—
01
—
217324
ANTHEM PROF TRIGON
—
01
—
269963
COMPSYCH
—
01
—
334969
VALUEOPTIONS GROUP
—
01
—
351654200
DOL WORKERS COMP
—
01
—
4013483
MAGELLAN NAVIGATOR
—
01
—
620582605
THREE RIVERS PROVI GROUP
—
Enumeration date
10/12/2006
Last updated
10/11/2019
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