Provider Demographics
NPI:1215057633
Name:BUCK, CHAD ANTHONY (PHD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:ANTHONY
Last Name:BUCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 TANKSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2427
Mailing Address - Country:US
Mailing Address - Phone:615-414-6016
Mailing Address - Fax:
Practice Address - Street 1:2021 21ST AVE S
Practice Address - Street 2:SUITE 448
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4342
Practice Address - Country:US
Practice Address - Phone:615-414-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2717103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical