Provider Demographics
NPI:1750057212
Name:SLEDGE-CARR, VANESSA ELAINE (LMSW)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ELAINE
Last Name:SLEDGE-CARR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-5019
Mailing Address - Country:US
Mailing Address - Phone:205-792-4112
Mailing Address - Fax:
Practice Address - Street 1:3053 CANAL ST
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-5019
Practice Address - Country:US
Practice Address - Phone:205-792-4112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000009084104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker