Provider Demographics
NPI:1841844495
Name:CRUTCHFIELD, JAMELUN ANNETTE (JAMELUN)
Entity type:Individual
Prefix:
First Name:JAMELUN
Middle Name:ANNETTE
Last Name:CRUTCHFIELD
Suffix:
Gender:F
Credentials:JAMELUN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 CRYSTAL SPRING LN
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-4191
Mailing Address - Country:US
Mailing Address - Phone:615-887-4505
Mailing Address - Fax:
Practice Address - Street 1:210 25TH AVE N STE 601
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1631
Practice Address - Country:US
Practice Address - Phone:615-873-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YM0800X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty