Provider Demographics
NPI:1750952305
Name:SIMPLIFIED PEACE BEHAVIORAL WELLNESS, LLC
Entity type:Organization
Organization Name:SIMPLIFIED PEACE BEHAVIORAL WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:931-446-5067
Mailing Address - Street 1:8434 NEW LAWRENCEBURG HWY
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TN
Mailing Address - Zip Code:38474-2165
Mailing Address - Country:US
Mailing Address - Phone:931-446-5067
Mailing Address - Fax:
Practice Address - Street 1:1149 NASHVILLE HWY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-2236
Practice Address - Country:US
Practice Address - Phone:931-446-5067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty