Provider Demographics
NPI:1003492562
Name:A SOUND MIND BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:A SOUND MIND BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:423-946-0044
Mailing Address - Street 1:403 BELLE GLEN LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5623
Mailing Address - Country:US
Mailing Address - Phone:423-946-0044
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1041
Practice Address - Country:US
Practice Address - Phone:615-445-7600
Practice Address - Fax:615-332-8939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1366871030Medicaid