MEDICARE: MR. CHRISTOPHER BRYAN ROBERTS MACP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	3119	TN

General Provider Information

NPI Number	:	1215180575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER BRYAN ROBERTS MACP

Provider Business Mailing Address
First Line	:	3915 ALBERT DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4007
Country	:	US
Telephone Number	:	615-800-9260
Fax Number	:

Provider Business Practice Location Address
First Line	:	3915 ALBERT DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4007
Country	:	US
Telephone Number	:	615-800-9260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	01/27/2015

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