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General NPI Number Information
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NPI Number | 1699216358
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Entity Type | Organization
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Legal Business Name | WESTSIDE PSYCH & WELLNESS, PLLC
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 2021 RICHARD JONES RD SUITE 350 B
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City | NASHVILLE
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State | TN
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Zip | 37215-2860
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Country | US
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Telephone | 615-561-5539
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Fax |
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Provider Business Mailing Address
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Address Line | 655 SHADOWOOD DR
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City | NASHVILLE
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State | TN
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Zip | 37205-4666
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Country | US
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Telephone | 615-561-5539
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Fax |
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Authorized Official
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Title or Position | THERAPIST, FOUNDING MEMBER
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Name | MR. BRIAN CURRY GRINER
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Credential | LPC-MHSP
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Telephone | 615-561-5539
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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 | 2911
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License Number State | TN
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