Provider Demographics
NPI:1225135049
Name:SOGOL, TERI R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TERI
Middle Name:R
Last Name:SOGOL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PERCY WARNER BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-4128
Mailing Address - Country:US
Mailing Address - Phone:615-354-1662
Mailing Address - Fax:615-353-2652
Practice Address - Street 1:801 PERCY WARNER BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4128
Practice Address - Country:US
Practice Address - Phone:615-354-1662
Practice Address - Fax:615-353-2652
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000030961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3921582Medicare ID - Type UnspecifiedPERFORMING PROVIDER NO.