Provider Demographics
NPI:1194900373
Name:DEES-JOHNSON, THELMA WILLENE (LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:THELMA
Middle Name:WILLENE
Last Name:DEES-JOHNSON
Suffix:
Gender:F
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 1:307 TYNE BLVD
Mailing Address - Street 2:PO BOX 132
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-1224
Mailing Address - Country:US
Mailing Address - Phone:615-838-0241
Mailing Address - Fax:615-754-1845
Practice Address - Street 1:307 TYNE BLVD
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-1224
Practice Address - Country:US
Practice Address - Phone:615-838-0241
Practice Address - Fax:615-754-1845
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty