Provider Demographics
NPI:1619160983
Name:BATTLE, BARRETT REGINALD (LA DAC)
Entity Type:Individual
Prefix:
First Name:BARRETT
Middle Name:REGINALD
Last Name:BATTLE
Suffix:
Gender:M
Credentials:LA DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CASTLE HEIGHTS AVE N STE 205
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2771
Mailing Address - Country:US
Mailing Address - Phone:615-444-0814
Mailing Address - Fax:
Practice Address - Street 1:115 CASTLE HEIGHTS AVE N STE 205
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2771
Practice Address - Country:US
Practice Address - Phone:615-444-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4506299101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)