Provider Demographics
NPI:1134711625
Name:CHASTEEN, MACKENZIE ELISE
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ELISE
Last Name:CHASTEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:
Other - Last Name:GRIMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5208 KALINE DR
Mailing Address - Street 2:
Mailing Address - City:ARRINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:37014-2021
Mailing Address - Country:US
Mailing Address - Phone:615-504-8175
Mailing Address - Fax:
Practice Address - Street 1:1604 WESTGATE CIR STE 150
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8047
Practice Address - Country:US
Practice Address - Phone:615-988-4954
Practice Address - Fax:615-622-8873
Is Sole Proprietor?:No
Enumeration Date:2021-02-07
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN289082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry