Provider Demographics
NPI:1083004584
Name:FOLLETT, ANDREW (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:FOLLETT
Suffix:
Gender:
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 WATERVIEW DR APT 315
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-9063
Mailing Address - Country:US
Mailing Address - Phone:865-441-5846
Mailing Address - Fax:
Practice Address - Street 1:507 MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSBORO
Practice Address - State:TN
Practice Address - Zip Code:37757-2967
Practice Address - Country:US
Practice Address - Phone:865-433-0489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty