Bruce Theobald, M.a., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2248 Issued in TN

Legal business name

BRUCE THEOBALD, M.A., LPC

Practice address

1107 Battlewood St
Franklin, TN 37069-6453

Phone

(615) 752-7625

NPI assigned

Sep 26, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bruce Theobald, LPC

Title

Owner

Phone

(615) 752-7625

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1245789791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 BATTLEWOOD ST",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370696453",
            "telephone_number": "615-752-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 BATTLEWOOD ST",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370696453",
            "telephone_number": "615-752-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE THEOBALD, M.A., LPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "THEOBALD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-752-7625",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "2248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Franklin, TN
• Providers in Franklin, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.