Provider Demographics
NPI:1083416309
Name:BOGAERT, ISABEL REBECCA
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:REBECCA
Last Name:BOGAERT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 OLD HICKORY BLVD APT 1711
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3727
Mailing Address - Country:US
Mailing Address - Phone:850-247-9128
Mailing Address - Fax:
Practice Address - Street 1:207 CHURCH ST
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1403
Practice Address - Country:US
Practice Address - Phone:407-205-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health