Provider Demographics
NPI:1720312556
Name:CHRISTIAN, MICHAEL M
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:CHRISTIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:M
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LPC-MHSP
Mailing Address - Street 1:7003 CHADWICK DR STE 335
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5282
Mailing Address - Country:US
Mailing Address - Phone:615-604-6853
Mailing Address - Fax:615-449-6853
Practice Address - Street 1:7003 CHADWICK DR STE 335
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5282
Practice Address - Country:US
Practice Address - Phone:615-604-6853
Practice Address - Fax:615-449-6853
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-27
Last Update Date:2009-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1951101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional