Provider Demographics
NPI:1598240707
Name:WOMBLE, DEXTER PIERRE (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:DEXTER
Middle Name:PIERRE
Last Name:WOMBLE
Suffix:
Gender:M
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 VENETIAN WAY
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3803
Mailing Address - Country:US
Mailing Address - Phone:615-396-8090
Mailing Address - Fax:
Practice Address - Street 1:120 DONELSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2911
Practice Address - Country:US
Practice Address - Phone:615-962-3181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000004327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional