Provider Demographics
NPI:1821869546
Name:PICKETT, AMY ELIZABETH (LADAC II)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:PICKETT
Suffix:
Gender:F
Credentials:LADAC II
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5515 EDMONDSON PIKE STE 118
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5871
Mailing Address - Country:US
Mailing Address - Phone:615-927-7802
Mailing Address - Fax:615-258-7881
Practice Address - Street 1:5515 EDMONDSON PIKE STE 118
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5871
Practice Address - Country:US
Practice Address - Phone:615-927-7802
Practice Address - Fax:615-258-7881
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN1642101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)