Provider Demographics
NPI:1275293748
Name:ANDERSEN, ELIZABETH (LPC-MHSP, RPT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:LPC-MHSP, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7118 FERNVALE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-9201
Mailing Address - Country:US
Mailing Address - Phone:615-415-1975
Mailing Address - Fax:
Practice Address - Street 1:810 DOMINICAN DR STE 316
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1906
Practice Address - Country:US
Practice Address - Phone:615-415-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4380101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional