Provider Demographics
NPI:1982012423
Name:SCALES, SAMUEL R (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:R
Last Name:SCALES
Suffix:
Gender:M
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 1:4546 ARTELIA DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-2721
Mailing Address - Country:US
Mailing Address - Phone:615-500-8223
Mailing Address - Fax:
Practice Address - Street 1:1916 PATTERSON ST STE 504
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2181
Practice Address - Country:US
Practice Address - Phone:615-285-9119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2443101YP2500X, 101YM0800X
TN002443101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional