Provider Demographics
NPI:1750990487
Name:CAIN, CHRIS (PHD, LADAC 2, CCS)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:CAIN
Suffix:
Gender:M
Credentials:PHD, LADAC 2, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 BEASLEY BEND RD
Mailing Address - Street 2:
Mailing Address - City:RIDDLETON
Mailing Address - State:TN
Mailing Address - Zip Code:37047
Mailing Address - Country:US
Mailing Address - Phone:629-666-1764
Mailing Address - Fax:
Practice Address - Street 1:92 BEASLEY BEND RD
Practice Address - Street 2:
Practice Address - City:RIDDLETON
Practice Address - State:TN
Practice Address - Zip Code:37047
Practice Address - Country:US
Practice Address - Phone:629-666-1764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22476101Y00000X, 102L00000X, 101YA0400X
TNLADAC-1729101YA0400X
KYLCADC-287326101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst