Provider Demographics
NPI:1467415018
Name:PADULA, KIM I (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:
Last Name:PADULA
Suffix:I
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:PO BOX 292434
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-2434
Mailing Address - Country:US
Mailing Address - Phone:615-418-0538
Mailing Address - Fax:615-361-3519
Practice Address - Street 1:420 N MAIN ST.
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072
Practice Address - Country:US
Practice Address - Phone:615-418-0538
Practice Address - Fax:615-361-3519
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW33521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical