Provider Demographics
NPI:1659081446
Name:BAUER, TATIANA MARIA (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:MARIA
Last Name:BAUER
Suffix:
Gender:F
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 1:226 HIGHLAND RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-1656
Mailing Address - Country:US
Mailing Address - Phone:931-287-5166
Mailing Address - Fax:
Practice Address - Street 1:226 HIGHLAND RIDGE DR
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-1656
Practice Address - Country:US
Practice Address - Phone:931-287-5166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5919101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health