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NPI 1699648204

NPI 1699648204 : WYNNE WHITLEY : NASHVILLE, TN

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General NPI Number Information
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    NPI Number           |    1699648204
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    Entity Type          |    Individual 
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    Provider Name        |    WYNNE WHITLEY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/29/2025
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    Last Update Date     |    09/29/2025
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Provider Practice Location Address
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    Address Line         |    2021 21ST AVE S STE C400 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37212-4350
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    Country              |    US
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    Telephone            |    615-492-6700
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1817 CEDAR LN 
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    City                 |    NASHVILLE
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    State                |    TN
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    Zip                  |    37212-5813
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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    |    
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    7401
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    License Number State |    TN
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