Provider Demographics
NPI:1346066057
Name:ARMSTRONG, JERELL (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:JERELL
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5805 LEE HWY STE 107
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3546
Mailing Address - Country:US
Mailing Address - Phone:423-380-1259
Mailing Address - Fax:800-701-6250
Practice Address - Street 1:5805 LEE HWY STE 107
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3546
Practice Address - Country:US
Practice Address - Phone:423-380-1259
Practice Address - Fax:800-701-6250
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6658101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional