Healthcare Provider Details

I. General information

NPI: 1588316442
Provider Name (Legal Business Name): DEMETRIA FIELDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 SHAFER DR
MURFREESBORO TN
37128-2880
US

IV. Provider business mailing address

803 MEADOWLARK LN
GOODLETTSVILLE TN
37072-2307
US

V. Phone/Fax

Practice location:
  • Phone: 901-496-2877
  • Fax:
Mailing address:
  • Phone: 615-756-4898
  • Fax: 615-747-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1528
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: