Provider Demographics
NPI:1487042123
Name:ROSENBLUM, JOANNA KAY (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:KAY
Last Name:ROSENBLUM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:JODIE
Other - Middle Name:
Other - Last Name:ROSENBLUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:620 GALLATIN PIKE S
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-4013
Mailing Address - Country:US
Mailing Address - Phone:615-460-4300
Mailing Address - Fax:615-460-4302
Practice Address - Street 1:620 GALLATIN PIKE S
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-4013
Practice Address - Country:US
Practice Address - Phone:615-460-4300
Practice Address - Fax:615-460-4302
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW9495104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker