Provider Demographics
NPI:1073069126
Name:WARREN, CAVERLY (MED, LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:CAVERLY
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:MED, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 21ST AVE S STE 300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4930
Mailing Address - Country:US
Mailing Address - Phone:615-544-5344
Mailing Address - Fax:
Practice Address - Street 1:2323 21ST AVE S STE 300
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4930
Practice Address - Country:US
Practice Address - Phone:615-544-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-29
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004335101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional