Provider Demographics
NPI:1396431235
Name:LADSHAW, KATHERINE LEE (MMFT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LEE
Last Name:LADSHAW
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2211
Mailing Address - Country:US
Mailing Address - Phone:615-319-6328
Mailing Address - Fax:
Practice Address - Street 1:116 WILSON PIKE CIR STE 207
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2752
Practice Address - Country:US
Practice Address - Phone:615-567-3214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist