MEDICARE: BRIAN CARDEN MMFT

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1366117525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN CARDEN MMFT

Provider Business Mailing Address
First Line	:	6201 CORINTH RD
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-7603
Country	:	US
Telephone Number	:	615-512-5257
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 CORINTH RD
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-7603
Country	:	US
Telephone Number	:	615-973-5454
Fax Number	:

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

Provider Enumeration Date	:	08/10/2021
Last Update Date	:	08/10/2021

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