Healthcare Provider Details

I. General information

NPI: 1346164035
Provider Name (Legal Business Name): TEEN MENTAL HEALTH TENNESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PLUS PARK BLVD STE 1
NASHVILLE TN
37217-1036
US

IV. Provider business mailing address

1464 E WHITESTONE BLVD STE 1304D
CEDAR PARK TX
78613-9072
US

V. Phone/Fax

Practice location:
  • Phone: 615-637-2902
  • Fax:
Mailing address:
  • Phone: 615-637-2902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TAYLOR CAVENDER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 615-637-2902