Provider Demographics
NPI:1447532205
Name:TT & S FAMILY FOUNDATION INC
Entity type:Organization
Organization Name:TT & S FAMILY FOUNDATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LPC-MHSP
Authorized Official - Prefix:MS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEES-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:6159-150-4074
Mailing Address - Street 1:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-0132
Mailing Address - Country:US
Mailing Address - Phone:615-915-4074
Mailing Address - Fax:615-942-6392
Practice Address - Street 1:319 PLUS PARK BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-1098
Practice Address - Country:US
Practice Address - Phone:615-915-4074
Practice Address - Fax:615-942-6342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2111101YM0800X, 101YP2500X, 106H00000X
TN3847104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445718Medicaid
TN5442020Medicaid