Provider Demographics
NPI:1477796548
Name:TATE, MIRIAM BOND (LPC)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:BOND
Last Name:TATE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 CHAPELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-6614
Mailing Address - Country:US
Mailing Address - Phone:615-794-0478
Mailing Address - Fax:
Practice Address - Street 1:624 GRASSMERE PARK
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3662
Practice Address - Country:US
Practice Address - Phone:615-837-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-19
Last Update Date:2009-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional