Provider Demographics
NPI:1982400628
Name:AWAKENED FAMILY THERAPY, PLLC
Entity type:Organization
Organization Name:AWAKENED FAMILY THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-217-3583
Mailing Address - Street 1:739 BLUFF CITY HWY
Mailing Address - Street 2:ST. 5
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-4637
Mailing Address - Country:US
Mailing Address - Phone:423-217-3583
Mailing Address - Fax:
Practice Address - Street 1:739 BLUFF CITY HWY
Practice Address - Street 2:ST. 5
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-4637
Practice Address - Country:US
Practice Address - Phone:423-217-3583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty