Provider Demographics
NPI:1427336189
Name:ROSENBLUM, JENNIFER PAIGE (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PAIGE
Last Name:ROSENBLUM
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 VILLA PL
Mailing Address - Street 2:SUITE 410
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3033
Mailing Address - Country:US
Mailing Address - Phone:615-474-3404
Mailing Address - Fax:
Practice Address - Street 1:1200 VILLA PL
Practice Address - Street 2:SUITE 410
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3033
Practice Address - Country:US
Practice Address - Phone:615-474-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2702101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health