Healthcare Provider Details

I. General information

NPI: 1477788735
Provider Name (Legal Business Name): STEVEN THOMAS OLIVAS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2009
Last Update Date: 07/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 BELLE FOREST CIR SUITE 302
NASHVILLE TN
37221-2111
US

IV. Provider business mailing address

PO BOX 210692
NASHVILLE TN
37221-0692
US

V. Phone/Fax

Practice location:
  • Phone: 615-473-5909
  • Fax: 615-662-1007
Mailing address:
  • Phone: 615-473-5909
  • Fax: 615-662-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberP00000002246
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: