Healthcare Provider Details

I. General information

NPI: 1477482081
Provider Name (Legal Business Name): PRUSINSKI THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 GALLATIN PIKE S
MADISON TN
37115-4009
US

IV. Provider business mailing address

1127 TUCKAHOE DR
NASHVILLE TN
37207-1640
US

V. Phone/Fax

Practice location:
  • Phone: 615-200-6281
  • Fax:
Mailing address:
  • Phone: 310-266-5044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MELISSE MARIE PRUSINSKI
Title or Position: OWNER
Credential: MS,LMFT
Phone: 310-266-5044