Provider Demographics
NPI:1073089975
Name:INTEGRATED HEALTH OF TN PLLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH OF TN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:352-843-1711
Mailing Address - Street 1:PO BOX 120164
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-0164
Mailing Address - Country:US
Mailing Address - Phone:352-843-1711
Mailing Address - Fax:
Practice Address - Street 1:2202 KNOWLES AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2100
Practice Address - Country:US
Practice Address - Phone:352-843-1711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty