Provider Demographics
NPI:1053895367
Name:HAZEL TREE COUNSELING
Entity type:Organization
Organization Name:HAZEL TREE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:LUNTZ
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-243-9970
Mailing Address - Street 1:84 MIDDLEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2557
Mailing Address - Country:US
Mailing Address - Phone:954-243-9970
Mailing Address - Fax:
Practice Address - Street 1:56 CLAYTON ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2424
Practice Address - Country:US
Practice Address - Phone:828-907-1392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health