Healthcare Provider Details

I. General information

NPI: 1639736325
Provider Name (Legal Business Name): CANDACE COPELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6018 TROUT LN
SPRING HILL TN
37174-4559
US

IV. Provider business mailing address

6018 TROUT LN
SPRING HILL TN
37174-4559
US

V. Phone/Fax

Practice location:
  • Phone: 615-478-7092
  • Fax:
Mailing address:
  • Phone: 615-478-7092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4730
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: