Provider Demographics
NPI:1235506353
Name:TAPESTRIES COUNSELING & ASSESSMENT, INC.
Entity type:Organization
Organization Name:TAPESTRIES COUNSELING & ASSESSMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:GOW
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:423-783-7995
Mailing Address - Street 1:1104 TUSCULUM BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4091
Mailing Address - Country:US
Mailing Address - Phone:423-783-7995
Mailing Address - Fax:
Practice Address - Street 1:1104 TUSCULUM BLVD STE 215
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4091
Practice Address - Country:US
Practice Address - Phone:423-783-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002836103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1526146Medicaid
TN103I685856Medicare PIN