Healthcare Provider Details

I. General information

NPI: 1003189226
Provider Name (Legal Business Name): ALISSA BEUERLEIN PH.D., LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2012
Last Update Date: 10/01/2022
Certification Date: 10/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 21ST AVE S STE 410
NASHVILLE TN
37212-4929
US

IV. Provider business mailing address

2200 21ST AVE S STE 410
NASHVILLE TN
37212-4929
US

V. Phone/Fax

Practice location:
  • Phone: 615-887-4667
  • Fax:
Mailing address:
  • Phone: 615-887-4667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2558
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: