Healthcare Provider Details

I. General information

NPI: 1679906283
Provider Name (Legal Business Name): DYANA NICOLE HERMANN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DYANA NICOLE COON MSSW

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 VENTURE CIR
NASHVILLE TN
37228-1604
US

IV. Provider business mailing address

230 VENTURE CIR
NASHVILLE TN
37228-1604
US

V. Phone/Fax

Practice location:
  • Phone: 615-460-4200
  • Fax: 615-460-4202
Mailing address:
  • Phone: 615-460-4200
  • Fax: 615-460-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904008277
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: