Provider Demographics
NPI:1356485205
Name:NASHVILLE NEUROPSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:NASHVILLE NEUROPSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:QUALLS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:615-321-0101
Mailing Address - Street 1:2011 CHURCH ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2000
Mailing Address - Country:US
Mailing Address - Phone:615-321-0101
Mailing Address - Fax:615-284-4679
Practice Address - Street 1:2011 CHURCH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2000
Practice Address - Country:US
Practice Address - Phone:615-321-0101
Practice Address - Fax:615-284-4679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2026103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty