Healthcare Provider Details

I. General information

NPI: 1982569471
Provider Name (Legal Business Name): OLIVIA BLAKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 21ST AVE S STE 306
NASHVILLE TN
37212-4929
US

IV. Provider business mailing address

948A BATTLEFIELD DR
NASHVILLE TN
37204-3037
US

V. Phone/Fax

Practice location:
  • Phone: 704-340-6595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2839
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: