Healthcare Provider Details

I. General information

NPI: 1790966182
Provider Name (Legal Business Name): KARINA FERNANDEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 SUNNY VIEW CT
LA VERGNE TN
37086-3948
US

IV. Provider business mailing address

107 SUNNY VIEW CT
LA VERGNE TN
37086-3948
US

V. Phone/Fax

Practice location:
  • Phone: 615-549-7905
  • Fax:
Mailing address:
  • Phone: 615-549-7905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6768
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: