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General NPI Number Information
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NPI Number | 1033988795
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Entity Type | Organization
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Legal Business Name | CHRIS NELSON
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 953 MAIN ST STE 109B
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City | NASHVILLE
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State | TN
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Zip | 37206-3628
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Country | US
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Telephone | 413-350-1199
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Fax |
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Provider Business Mailing Address
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Address Line | 803 NELLA DR
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER NELSON
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Credential | LMFT
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Telephone | 413-350-1199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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