NPIMap

Organization Active NPI

Ebenezer Counseling Services

  • Professional Counselor
  • Knoxville, TN
National Provider Identifier
1962703249
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7104416 Issued in TN
Legal business name
EBENEZER COUNSELING SERVICES
Practice address
131 N Concord St
Knoxville, TN 37919-2330
Phone
(865) 670-0988
Fax
(865) 670-1991
NPI assigned
Nov 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Authorized official

Name
Mr. Dale T. Berry, PH.D.
Title
Clinical Director & Licensed Psycho
Phone
(865) 670-0988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 7104416 TN Primary

Addresses

Primary practice location

131 N Concord St
Knoxville, TN 37919-2330

Mailing address

325 Ebenezer Rd
Knoxville, TN 37923-5310
Phone (865) 670-0988

National Provider Directory

National Provider Directory

Locations

325 Ebenezer Rd
Knoxville, TN 37923
Phone (865) 670-0988

131 N Concord St
Knoxville, TN 37919
Phone (865) 670-0988

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1962703249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 EBENEZER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235310",
            "telephone_number": "865-670-0988",
            "fax_number": "865-670-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N CONCORD ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192330",
            "telephone_number": "865-670-0988",
            "fax_number": "865-670-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR & LICENSED PSYCHO",
        "authorized_official_telephone_number": "865-670-0988",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "7104416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.