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|
953 Main St Ste 109b Nashville TN 37206-3628 | |
| (413) 350-1199 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 953 Main St Ste 109b, Nashville, Tennessee |
| Authorized Official Name and Position | Christopher Nelson (OWNER) |
| Authorized Official Contact | 4133501199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
803 Nella Dr Goodlettsville TN 37072-3013 Ph: () - | 953 Main St Ste 109b Nashville TN 37206-3628 Ph: (413) 350-1199 |
| NPI Number | 1033988795 |
|---|---|
| Provider Enumeration Date | 12/21/2023 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 1355887266 |
|---|---|
| Medicare Enrollment ID | O20240726001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033988795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Christopher Nelson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1740794189 PECOS PAC ID: 2264978170 Enrollment ID: I20240726001374 |
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