Healthcare Provider Details

I. General information

NPI: 1104621606
Provider Name (Legal Business Name): RAVEN GELDER MMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 DICKERSON PIKE
NASHVILLE TN
37207-5354
US

IV. Provider business mailing address

95 WHITE BRIDGE PIKE STE 400
NASHVILLE TN
37205-1426
US

V. Phone/Fax

Practice location:
  • Phone: 512-876-3634
  • Fax:
Mailing address:
  • Phone:
  • 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:
Title or Position:
Credential:
Phone: