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Individual

COURTLAND ALEXANDER VANSANT PICKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NCC, LPC/MHSP TEMP

Contact information

Practice address
2298 S GERMANTOWN RD, GERMANTOWN, TN 38138-5962
(901) 481-9877
Mailing address
2298 S GERMANTOWN RD, GERMANTOWN, TN 38138-5962
(901) 481-9877

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
706951
101YP2500X
Professional Counselor
Primary
4268
TN

Other

Enumeration date
12/09/2019
Last updated
12/09/2019
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