Provider Demographics
NPI:1871220822
Name:ASCEND COACHING AND THERAPY INC
Entity type:Organization
Organization Name:ASCEND COACHING AND THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALINE
Authorized Official - Middle Name:BETHEA TALMAGE
Authorized Official - Last Name:DEFIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MPH
Authorized Official - Phone:770-894-9693
Mailing Address - Street 1:4127 BRIAR ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-2605
Mailing Address - Country:US
Mailing Address - Phone:770-894-9693
Mailing Address - Fax:
Practice Address - Street 1:6237 VANCE RD STE 4
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2954
Practice Address - Country:US
Practice Address - Phone:773-888-2713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1477998334Medicaid