Provider Demographics
NPI:1306072624
Name:TULLY, CAROL ANN (LPC, MHSP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:TULLY
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 1:106 MISSION CT
Mailing Address - Street 2:SUITE 904B
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6440
Mailing Address - Country:US
Mailing Address - Phone:615-294-1192
Mailing Address - Fax:
Practice Address - Street 1:106 MISSION CT
Practice Address - Street 2:SUITE 904B
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6440
Practice Address - Country:US
Practice Address - Phone:615-294-1192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2428101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional