Bethany Joy Rougemont, GED
Individual provider Active NPI Professional Counselor · Tennessee Ridge, TN
NPI 1992834204 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992834204
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 1330 N Main St
Tennessee Ridge, TN 37178-4003 - Phone
- (931) 721-3312
- NPI assigned
- Mar 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106116407 | TN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centerstone of Tennessee, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | TN | Yes |
Addresses
Primary practice location
1330 N Main St
Tennessee Ridge, TN 37178-4003
Mailing address
1330 N Main St
Tennessee Ridge, TN 37178-4003
Phone (931) 721-3312
Other providers in Tennessee Ridge, TN
- Robert Mullikin
- Martha Jeanette Murray
- Rachel Lillian Myers
- Izzabella Marie Pogreba
- Macha J Ross
- Barbara E Scott
- Torrey Seay
- Amanda Dawn Self
- Olivia Faith Sims
- Jodi Lynn Smith
All providers in Tennessee Ridge, TN · Professional Counselor in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.