Healthcare Provider Details

I. General information

NPI: 1053227330
Provider Name (Legal Business Name): LISA HOLTKAMP THEARPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 LISCHEY AVE
NASHVILLE TN
37207-5106
US

IV. Provider business mailing address

1501 LISCHEY AVE
NASHVILLE TN
37207-5106
US

V. Phone/Fax

Practice location:
  • Phone: 615-200-0439
  • Fax:
Mailing address:
  • Phone: 615-200-0439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA HOLTKAMP
Title or Position: OWNER
Credential: LPC-MHSP
Phone: 615-200-0439