MEDICARE: CHRISTINA LAFFERTY LPC-MHSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4052	TN

General Provider Information

NPI Number	:	1225631716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA LAFFERTY LPC-MHSP

Provider Business Mailing Address
First Line	:	1005 BURCHWOOD AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37216-3607
Country	:	US
Telephone Number	:	863-991-3877
Fax Number	:

Provider Business Practice Location Address
First Line	:	3925 GALLATIN PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37216-2405
Country	:	US
Telephone Number	:	863-991-3877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2020
Last Update Date	:	11/18/2020

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