Provider Demographics
NPI:1447442140
Name:OCOEE COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:OCOEE COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:V
Authorized Official - Last Name:TERPSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:423-559-3129
Mailing Address - Street 1:2189 APD 40
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323-6597
Mailing Address - Country:US
Mailing Address - Phone:423-559-3129
Mailing Address - Fax:423-559-3129
Practice Address - Street 1:2189 APD 40
Practice Address - Street 2:SUITE #1
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37323-6597
Practice Address - Country:US
Practice Address - Phone:423-559-3129
Practice Address - Fax:423-559-3129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty