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General NPI Number Information
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NPI Number | 1598959983
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Entity Type | Individual
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Provider Name | GRACE A BLUEROCK LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 05/03/2020
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Provider Practice Location Address
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Address Line | 125 COOL SPRINGS BLVD STE 270
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City | FRANKLIN
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State | TN
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Zip | 37067-6574
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Country | US
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Telephone | 615-549-5506
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Fax | 615-647-0748
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Provider Business Mailing Address
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Address Line | 5651 FRIST BLVD STE 712
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City | HERMITAGE
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State | TN
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Zip | 37076-2061
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Country | US
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Telephone | 615-872-9966
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Fax | 615-872-9967
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4875
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License Number State | TN
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