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General NPI Number Information
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NPI Number | 1255580908
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Entity Type | Organization
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Legal Business Name | ASSIST BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 623 E MAIN ST SUITE 4
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2690
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Country | US
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Telephone | 615-828-8488
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Fax | 615-826-8290
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Provider Business Mailing Address
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Address Line | 623 E MAIN ST SUITE 4
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2690
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Country | US
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Telephone | 615-828-8488
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Fax | 615-826-8290
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | NATHAN A. DE GRAAF
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Credential | L.C.S.W.
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Telephone | 615-828-8488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 3866
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License Number State | TN
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