Provider Demographics
NPI:1538407697
Name:CHASE, STEPHANIE BELLARD (PHD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:BELLARD
Last Name:CHASE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 COMMERCE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-3714
Mailing Address - Country:US
Mailing Address - Phone:615-481-3386
Mailing Address - Fax:
Practice Address - Street 1:520 COMMERCE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-3714
Practice Address - Country:US
Practice Address - Phone:615-481-3386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002588103T00000X
OH6553103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist