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NPI 1053715151

NPI 1053715151 : VICKI L MEAD LPC/MHSP : NASHVILLE, TN

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General NPI Number Information
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    NPI Number           |    1053715151
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    Entity Type          |    Individual 
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    Provider Name        |    VICKI L MEAD LPC/MHSP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/17/2014
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    Last Update Date     |    10/17/2014
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Provider Practice Location Address
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    Address Line         |    2000 WARFIELD DR 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37215-3424
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    Country              |    US
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    Telephone            |    615-594-2514
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2702 FAIRFAX AVE 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37212-3309
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    Country              |    US
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    Telephone            |    615-594-2514
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    1881
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    License Number State |    TN
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