Healthcare Provider Details

I. General information

NPI: 1962248765
Provider Name (Legal Business Name): ELDERBERRY PSYCHIATRIC CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 CALDWELL DR STE 500
GOODLETTSVILLE TN
37072-3410
US

IV. Provider business mailing address

6339 CHARLOTTE PIKE # 1027
NASHVILLE TN
37209-2926
US

V. Phone/Fax

Practice location:
  • Phone: 615-239-1404
  • Fax: 615-900-2716
Mailing address:
  • Phone: 615-434-4892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEAN M. SALCEDO
Title or Position: FOUNDER
Credential: MD, MBA
Phone: 615-434-4892