Provider Demographics
NPI:1598959983
Name:BLUEROCK, GRACE A (LCSW)
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:A
Last Name:BLUEROCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5651 FRIST BLVD STE 712
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2061
Mailing Address - Country:US
Mailing Address - Phone:615-872-9966
Mailing Address - Fax:615-872-9967
Practice Address - Street 1:125 COOL SPRINGS BLVD STE 270
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6574
Practice Address - Country:US
Practice Address - Phone:615-549-5506
Practice Address - Fax:615-647-0748
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical