Healthcare Provider Details

I. General information

NPI: 1720779754
Provider Name (Legal Business Name): EMILY BURGESS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 TANYARD SPRINGS DR
SPRING HILL TN
37174-6131
US

IV. Provider business mailing address

1022 TANYARD SPRINGS DR
SPRING HILL TN
37174-6131
US

V. Phone/Fax

Practice location:
  • Phone: 615-337-3661
  • Fax:
Mailing address:
  • Phone: 615-337-3661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10524
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: