Healthcare Provider Details

I. General information

NPI: 1225167471
Provider Name (Legal Business Name): KENNETH L SAEFKOW LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 S 7TH ST
NASHVILLE TN
37206-3815
US

IV. Provider business mailing address

409 W DUE WEST AVE
MADISON TN
37115-4403
US

V. Phone/Fax

Practice location:
  • Phone: 615-254-1791
  • Fax:
Mailing address:
  • Phone: 615-856-2206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1134
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: