Provider Demographics
NPI:1639925118
Name:GLADDEN, JESSIE BETH (LPC-T)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:BETH
Last Name:GLADDEN
Suffix:
Gender:F
Credentials:LPC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 25TH AVE N STE 1010
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1651
Mailing Address - Country:US
Mailing Address - Phone:615-283-0752
Mailing Address - Fax:
Practice Address - Street 1:210 25TH AVE N STE 1010
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1651
Practice Address - Country:US
Practice Address - Phone:615-283-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health