Provider Demographics
NPI:1750060646
Name:STEADFAST LIVING THERAPY, LLC
Entity type:Organization
Organization Name:STEADFAST LIVING THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:THANE
Authorized Official - Last Name:MILAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:615-208-7187
Mailing Address - Street 1:103 CONTINENTAL PL STE 204
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1041
Mailing Address - Country:US
Mailing Address - Phone:615-208-7187
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL STE 204
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1041
Practice Address - Country:US
Practice Address - Phone:615-208-7187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health