Healthcare Provider Details

I. General information

NPI: 1386563617
Provider Name (Legal Business Name): SARAH WHITLEY GAGNON LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH WHITLEY TURNER LPC-MHSP

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9580 S LICK CREEK RD STE B
LYLES TN
37098-3015
US

IV. Provider business mailing address

9580 S LICK CREEK RD STE B
LYLES TN
37098-3015
US

V. Phone/Fax

Practice location:
  • Phone: 615-295-6889
  • Fax:
Mailing address:
  • Phone: 615-295-6889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6309
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: