MEDICARE: DR. STEPHEN L TENCH PH.D.

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	103T00000X	Psychologist	P1137	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	175813	OTHER	TN	COMPSYCH
3	04052600	OTHER	TN	MAGELLAN
4	4309527	OTHER	TN	AETNA
5	012562	OTHER	TN	VALUE OPTIONS
6	3158688	OTHER	TN	BLUE CROSS BLUE SHIELD
7	47553	OTHER	TN	CIGNA

General Provider Information

NPI Number	:	1245223148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN L TENCH PH.D.

Provider Business Mailing Address
First Line	:	5653 FRIST BLVD
Second Line	:	SUITE 331
City	:	HERMITAGE
State	:	TN
Zip	:	37076-2062
Country	:	US
Telephone Number	:	615-889-4447
Fax Number	:	615-889-5891

Provider Business Practice Location Address
First Line	:	5653 FRIST BLVD
Second Line	:	SUITE 331
City	:	HERMITAGE
State	:	TN
Zip	:	37076-2062
Country	:	US
Telephone Number	:	615-889-4447
Fax Number	:	615-889-5891

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. STEPHEN L TENCH PH.D.” Practice Location

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