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General NPI Number Information
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NPI Number | 1881109957
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Entity Type | Individual
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Provider Name | ELIZABETH G. SCOVILLE M.S., LPC-MHSP (T)
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Gender | Female
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Dates
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Enumeration Date | 12/11/2017
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 805 BRADFORD AVE
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City | NASHVILLE
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State | TN
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Zip | 37204-2105
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Country | US
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Telephone | 615-334-8494
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Fax |
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Provider Business Mailing Address
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Address Line | 404 MERCOMATIC DR APT 103
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City | NASHVILLE
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State | TN
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Zip | 37209-3051
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Country | US
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Telephone | 615-417-3661
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4674
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License Number State | TN
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