Provider Demographics
NPI:1821870197
Name:SHANEBROOK, TASSEL FAITH (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:TASSEL
Middle Name:FAITH
Last Name:SHANEBROOK
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4754
Mailing Address - Country:US
Mailing Address - Phone:615-618-0875
Mailing Address - Fax:
Practice Address - Street 1:4110 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4754
Practice Address - Country:US
Practice Address - Phone:615-618-0875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1679106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist