Provider Demographics
NPI:1518209634
Name:REALISTIC INTERVENTIONS
Entity Type:Organization
Organization Name:REALISTIC INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SHONTS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:615-445-5990
Mailing Address - Street 1:130 IMPERIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3440
Mailing Address - Country:US
Mailing Address - Phone:615-445-5990
Mailing Address - Fax:
Practice Address - Street 1:130 IMPERIAL BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:615-445-5990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty