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General NPI Number Information
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NPI Number | 1770640757
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Entity Type | Individual
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Provider Name | NATHAN A. DE GRAAF L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 623 E MAIN ST STE 4
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2641
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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 | 103 DEER RIDGE LN
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-5078
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Country | US
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Telephone | 615-826-8290
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Fax | 615-826-8290
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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 | 3866
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License Number State | TN
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