Provider Demographics
NPI:1124549076
Name:SANDERLIN, ALICE (PHD, LPC-MHSP)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:
Last Name:SANDERLIN
Suffix:
Gender:F
Credentials:PHD, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 PLYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-6910
Mailing Address - Country:US
Mailing Address - Phone:615-268-0627
Mailing Address - Fax:
Practice Address - Street 1:1222 16TH AVE S STE 24
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2926
Practice Address - Country:US
Practice Address - Phone:615-268-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health