Provider Demographics
NPI:1306174263
Name:THERAPEUTIC & EDUCATIONAL SERVICES, INC
Entity type:Organization
Organization Name:THERAPEUTIC & EDUCATIONAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, THERAPIST, CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:RAE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NETTLES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/MFT
Authorized Official - Phone:912-656-4227
Mailing Address - Street 1:7505 WATERS AVE
Mailing Address - Street 2:D-5
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3825
Mailing Address - Country:US
Mailing Address - Phone:912-656-4227
Mailing Address - Fax:912-257-4407
Practice Address - Street 1:7505 WATERS AVE
Practice Address - Street 2:D-5
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3825
Practice Address - Country:US
Practice Address - Phone:912-656-4227
Practice Address - Fax:912-257-4407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT 001054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty