Provider Demographics
NPI:1194019034
Name:STRIDE, STEVE (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:STRIDE
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 1:3735 N MOUNT JULIET RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3060
Mailing Address - Country:US
Mailing Address - Phone:615-947-6039
Mailing Address - Fax:
Practice Address - Street 1:3735 NORTH MOUNT JULIET ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122
Practice Address - Country:US
Practice Address - Phone:615-947-6039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2999103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical