Healthcare Provider Details

I. General information

NPI: 1487462479
Provider Name (Legal Business Name): SCOTT PHILLIPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2024
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 POTOMAC PL STE 403
SMYRNA TN
37167-5657
US

IV. Provider business mailing address

237 CORNICE DR
LA VERGNE TN
37086-2148
US

V. Phone/Fax

Practice location:
  • Phone: 615-900-4272
  • Fax:
Mailing address:
  • Phone: 615-663-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: