MEDICARE: CHARLES TIMOTHY HONEYCUTT MA, LPE

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	103T00000X	Psychologist	PE0000011626	TN

General Provider Information

NPI Number	:	1871900993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES TIMOTHY HONEYCUTT MA, LPE

Provider Business Mailing Address
First Line	:	319 S 4TH ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-4103
Country	:	US
Telephone Number	:	615-244-4802
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 S 4TH ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37206-4103
Country	:	US
Telephone Number	:	615-244-4802
Fax Number	:

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

Provider Enumeration Date	:	07/21/2014
Last Update Date	:	07/21/2014

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