Provider Demographics
NPI:1134475668
Name:SIEVEKING, NICHOLAS A (PHD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:A
Last Name:SIEVEKING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 HILLSBORO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5412
Mailing Address - Country:US
Mailing Address - Phone:615-426-4212
Mailing Address - Fax:615-730-5790
Practice Address - Street 1:102 WOODMONT BLVD
Practice Address - Street 2:SUITE 530
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2287
Practice Address - Country:US
Practice Address - Phone:615-426-4212
Practice Address - Fax:615-730-5790
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP176103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical