Provider Demographics
NPI:1386832590
Name:KATHRYN SHERROD
Entity Type:Organization
Organization Name:KATHRYN SHERROD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHERROD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:615-298-2329
Mailing Address - Street 1:2400 CRESTMOOR RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2032
Mailing Address - Country:US
Mailing Address - Phone:615-298-2329
Mailing Address - Fax:615-298-1248
Practice Address - Street 1:2400 CRESTMOOR RD
Practice Address - Street 2:SUITE 210
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2032
Practice Address - Country:US
Practice Address - Phone:615-298-2329
Practice Address - Fax:615-298-1248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP971251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN40605OtherBLUE CROSS BLUE SHIELD