MEDICARE: CDS VENTURES, LLC

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	3001	TN

General Provider Information

NPI Number	:	1760816565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CDS VENTURES, LLC

Provider Business Mailing Address
First Line	:	1633 W MAIN ST STE 902
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-7800
Country	:	US
Telephone Number	:	615-220-6005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1633 W MAIN ST STE 902
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-7800
Country	:	US
Telephone Number	:	615-220-6005
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. DAWN-ELISE SNIPES
Credential	:	PHD LPC-MHSP, LMHC
Telephone Number	:	615-220-6005

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	08/28/2013

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Directions to “CDS VENTURES, LLC ” Practice Location

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