Provider Demographics
NPI:1316069271
Name:WEISS-SHARP, ALIX (PHD, LCSW, PC)
Entity type:Individual
Prefix:DR
First Name:ALIX
Middle Name:
Last Name:WEISS-SHARP
Suffix:
Gender:F
Credentials:PHD, LCSW, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 21ST AVE S
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4930
Mailing Address - Country:US
Mailing Address - Phone:615-297-6808
Mailing Address - Fax:615-292-2355
Practice Address - Street 1:2323 21ST AVE S
Practice Address - Street 2:SUITE 401
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4930
Practice Address - Country:US
Practice Address - Phone:615-297-6808
Practice Address - Fax:615-292-2355
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN49877Medicare UPIN
TN3694772Medicare ID - Type Unspecified