Healthcare Provider Details

I. General information

NPI: 1073881561
Provider Name (Legal Business Name): JEFFREY EASTMAN LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BURTON HILLS BLVD STE 200
NASHVILLE TN
37215-5902
US

IV. Provider business mailing address

40 BURTON HILLS BLVD STE 200
NASHVILLE TN
37215-5902
US

V. Phone/Fax

Practice location:
  • Phone: 513-202-3009
  • Fax:
Mailing address:
  • Phone: 513-202-3009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number88523
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-5455
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-4825
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: