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General NPI Number Information
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NPI Number | 1790459105
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Entity Type | Organization
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Legal Business Name | THE GAIA CENTER FOR EMBODIED HEALING
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Dates
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Enumeration Date | 08/09/2021
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Last Update Date | 08/09/2021
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Provider Practice Location Address
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Address Line | 95 WHITE BRIDGE PIKE STE 405
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City | NASHVILLE
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State | TN
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Zip | 37205-1488
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Country | US
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Telephone | 615-270-8117
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Fax |
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Provider Business Mailing Address
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Address Line | 95 WHITE BRIDGE PIKE STE 405
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City | NASHVILLE
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State | TN
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Zip | 37205-1488
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Country | US
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Telephone | 615-270-8117
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CLINICAL DIRECTOR
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Name | VALERIE MARTIN
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Credential | LCSW
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Telephone | 615-617-4947
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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