MEDICARE: CAROLINE LUGAR

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	101Y00000X	Counselor		TN

General Provider Information

NPI Number	:	1861142630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE LUGAR

Provider Business Mailing Address
First Line	:	589 STEWARTS FERRY PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-3414
Country	:	US
Telephone Number	:	629-255-0516
Fax Number	:

Provider Business Practice Location Address
First Line	:	589 STEWARTS FERRY PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-3414
Country	:	US
Telephone Number	:	629-255-0516
Fax Number	:

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

Provider Enumeration Date	:	03/25/2022
Last Update Date	:	03/25/2022

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