Provider Demographics
NPI:1336445824
Name:HALL, TRACY DANIEL (PHD, MFT)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:DANIEL
Last Name:HALL
Suffix:
Gender:M
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6880 SCARLET RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8820
Mailing Address - Country:US
Mailing Address - Phone:615-852-7399
Mailing Address - Fax:
Practice Address - Street 1:4555 TROUSDALE DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-4513
Practice Address - Country:US
Practice Address - Phone:615-781-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLMT0000000906106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist