Provider Demographics
NPI:1558880427
Name:BASSHAM, ALLISON (LAC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BASSHAM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:LINCOLN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1113 MURFREESBORO RD STE 319
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1312
Mailing Address - Country:US
Mailing Address - Phone:615-790-0567
Mailing Address - Fax:615-814-2924
Practice Address - Street 1:1113 MURFREESBORO RD STE 202
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064
Practice Address - Country:US
Practice Address - Phone:615-790-0567
Practice Address - Fax:615-814-2924
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1705209101YM0800X
TN1599106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health