MEDICARE: AARON PETRIE 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	101YP2500X	Professional Counselor	6077	TN

General Provider Information

NPI Number	:	1356072409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON PETRIE LPC-MHSP

Provider Business Mailing Address
First Line	:	3608A WILBUR PL
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-3829
Country	:	US
Telephone Number	:	210-803-9758
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 HILLSBORO PIKE STE 101
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-3314
Country	:	US
Telephone Number	:	615-212-9549
Fax Number	:

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

Provider Enumeration Date	:	06/20/2022
Last Update Date	:	05/08/2023

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