Healthcare Provider Details

I. General information

NPI: 1528665148
Provider Name (Legal Business Name): KATHRYN ROSE WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 POWELL PL # 1095
NASHVILLE TN
37204-3622
US

IV. Provider business mailing address

100 POWELL PL # 1095
NASHVILLE TN
37204-3622
US

V. Phone/Fax

Practice location:
  • Phone: 615-829-6496
  • Fax:
Mailing address:
  • Phone: 615-829-6496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5001
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number09750
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number405805
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: