Provider Demographics
NPI:1063598159
Name:GWIN, ANN D (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:D
Last Name:GWIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:GWIN
Other - Last Name:HASKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1060 TODD PREIS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2478
Mailing Address - Country:US
Mailing Address - Phone:615-646-7237
Mailing Address - Fax:615-673-7749
Practice Address - Street 1:2300 21ST AVE S
Practice Address - Street 2:SUITE 302
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4927
Practice Address - Country:US
Practice Address - Phone:615-646-7237
Practice Address - Fax:615-673-7749
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000008501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN246697OtherAETNA
TN0191852OtherBLUE CROSS BLUE SHIELD
TN3927063Medicare ID - Type UnspecifiedPERFORMING PROVIDER NUMBE