Provider Demographics
NPI:1215111059
Name:COMBS, BEDFORD MOORE (LMFT)
Entity type:Individual
Prefix:
First Name:BEDFORD
Middle Name:MOORE
Last Name:COMBS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 ELKINS AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3648
Mailing Address - Country:US
Mailing Address - Phone:615-297-4292
Mailing Address - Fax:615-297-4730
Practice Address - Street 1:4510 ELKINS AVE
Practice Address - Street 2:PO 90911
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3648
Practice Address - Country:US
Practice Address - Phone:615-297-4292
Practice Address - Fax:615-297-4730
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist