Healthcare Provider Details

I. General information

NPI: 1871650382
Provider Name (Legal Business Name): SCARAB BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 03/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3203 BRICK CHURCH PIKE
NASHVILLE TN
37207-2800
US

IV. Provider business mailing address

3203 BRICK CHURCH PIKE
NASHVILLE TN
37207-2800
US

V. Phone/Fax

Practice location:
  • Phone: 615-262-7822
  • Fax: 615-262-7823
Mailing address:
  • Phone: 615-262-7822
  • Fax: 615-262-7823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2120
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4212
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3946
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number731
License Number StateTN

VIII. Authorized Official

Name: MS. TIFFANY L BROWN
Title or Position: CREDENTIALING OFFICER
Credential:
Phone: 615-262-7822