Provider Demographics
NPI:1669785655
Name:NUSSER, CHRISTINE (LCSW, MBA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:NUSSER
Suffix:
Gender:F
Credentials:LCSW, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37116-0912
Mailing Address - Country:US
Mailing Address - Phone:615-513-6820
Mailing Address - Fax:
Practice Address - Street 1:1404 INDIAN WOODS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5040
Practice Address - Country:US
Practice Address - Phone:615-513-6820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW2841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical