Healthcare Provider Details

I. General information

NPI: 1972120426
Provider Name (Legal Business Name): JOYBRIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 GATEWAY LN
NASHVILLE TN
37220-1006
US

IV. Provider business mailing address

5203 MARYLAND WAY STE 104
BRENTWOOD TN
37027-5022
US

V. Phone/Fax

Practice location:
  • Phone: 615-585-4824
  • Fax:
Mailing address:
  • Phone: 615-560-6622
  • Fax: 615-560-6636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JESSE ROGERS CLAYTON
Title or Position: PRESIDENT
Credential:
Phone: 615-585-4824