Healthcare Provider Details

I. General information

NPI: 1073198164
Provider Name (Legal Business Name): LEE CAVENDER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209E HENSLEE DR
DICKSON TN
37055-2089
US

IV. Provider business mailing address

PO BOX 2024
DICKSON TN
37056-2024
US

V. Phone/Fax

Practice location:
  • Phone: 828-407-8987
  • Fax:
Mailing address:
  • Phone: 828-407-8987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6451
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107405
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: