Healthcare Provider Details

I. General information

NPI: 1083376461
Provider Name (Legal Business Name): MARGUERITE ANNE FLYNN MSSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5217 MARYLAND WAY STE 307
BRENTWOOD TN
37027-1056
US

IV. Provider business mailing address

5217 MARYLAND WAY STE 307
BRENTWOOD TN
37027-1056
US

V. Phone/Fax

Practice location:
  • Phone: 615-882-1792
  • Fax: 615-807-3714
Mailing address:
  • Phone: 615-882-1792
  • Fax: 615-807-3714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number000224899
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8938
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: