Healthcare Provider Details

I. General information

NPI: 1023189768
Provider Name (Legal Business Name): NANCY J ACHUFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 KNOLLWOOD DR
LA VERGNE TN
37086-4152
US

IV. Provider business mailing address

612 KNOLLWOOD DR
LA VERGNE TN
37086-4152
US

V. Phone/Fax

Practice location:
  • Phone: 615-400-0214
  • Fax:
Mailing address:
  • Phone: 615-400-0214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4701
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: