Provider Demographics
NPI:1104786631
Name:SHAH, NIMA BHADRESHKUMAR (RBT)
Entity type:Individual
Prefix:
First Name:NIMA
Middle Name:BHADRESHKUMAR
Last Name:SHAH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4541 SKYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-3080
Mailing Address - Country:US
Mailing Address - Phone:615-693-4882
Mailing Address - Fax:
Practice Address - Street 1:2710 OLD LEBANON PIKE STE 25
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2149
Practice Address - Country:US
Practice Address - Phone:615-905-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-25-491328106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician