Provider Demographics
NPI:1679382352
Name:JENISYS BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:JENISYS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KENNARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:423-773-3509
Mailing Address - Street 1:411 DOGWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:PINEY FLATS
Mailing Address - State:TN
Mailing Address - Zip Code:37686-4314
Mailing Address - Country:US
Mailing Address - Phone:423-773-3509
Mailing Address - Fax:
Practice Address - Street 1:411 DOGWOOD TRL
Practice Address - Street 2:
Practice Address - City:PINEY FLATS
Practice Address - State:TN
Practice Address - Zip Code:37686-4314
Practice Address - Country:US
Practice Address - Phone:423-773-3509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty