Tellico Bay Counseling & Wellness Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC0000001953 Issued in TN

Legal business name

TELLICO BAY COUNSELING & WELLNESS CENTER

Practice address

104 Dawson St
Vonore, TN 37885-2416

Phone

(423) 884-2479

Fax

(423) 884-2491

NPI assigned

Dec 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shirley Amanda Sexton, MS, MHC, NCC

Title

Ceo

Phone

(423) 884-2479

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639239791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DAWSON ST",
            "city": "VONORE",
            "state": "TN",
            "postal_code": "378852416",
            "telephone_number": "423-884-2479",
            "fax_number": "423-884-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DAWSON ST",
            "city": "VONORE",
            "state": "TN",
            "postal_code": "378852416",
            "telephone_number": "423-884-2479",
            "fax_number": "423-884-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELLICO BAY COUNSELING & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEXTON",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "AMANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-884-2479",
        "authorized_official_credential": "MS, MHC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "LPC0000001953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Vonore, TN
• Providers in Vonore, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.