Provider Demographics
NPI:1790459105
Name:THE GAIA CENTER FOR EMBODIED HEALING
Entity Type:Organization
Organization Name:THE GAIA CENTER FOR EMBODIED HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:615-617-4947
Mailing Address - Street 1:95 WHITE BRIDGE PIKE STE 405
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1488
Mailing Address - Country:US
Mailing Address - Phone:615-270-8117
Mailing Address - Fax:
Practice Address - Street 1:95 WHITE BRIDGE PIKE STE 405
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1488
Practice Address - Country:US
Practice Address - Phone:615-270-8117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty