Healthcare Provider Details

I. General information

NPI: 1285412452
Provider Name (Legal Business Name): LINDSEY NIEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 MCMINNVILLE HWY
MANCHESTER TN
37355-3179
US

IV. Provider business mailing address

831 RIDGE VIEW DR
SPENCER TN
38585-4926
US

V. Phone/Fax

Practice location:
  • Phone: 931-444-1000
  • Fax:
Mailing address:
  • Phone: 407-808-4505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: