Healthcare Provider Details

I. General information

NPI: 1467868778
Provider Name (Legal Business Name): SARAH KMITA LPC/MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 DIVISION ST STE 405
NASHVILLE TN
37203-4495
US

IV. Provider business mailing address

1200 DIVISION ST STE 405
NASHVILLE TN
37203-4495
US

V. Phone/Fax

Practice location:
  • Phone: 615-274-8400
  • Fax: 615-777-3646
Mailing address:
  • Phone: 615-274-8400
  • Fax: 615-777-3646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2955
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: