Organization
SOUTHERN ANGELS COMPREHENSIVE SUPPORT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANNA M. ANDERSON (OWENER/CEO)
(615) 657-9123
Entity
Organization
Contact information
Practice address
4243 LEBANON PIKE STE C, HERMITAGE, TN 37076-2170
(615) 600-5107
Mailing address
4243 LEBANON PIKE STE C, HERMITAGE, TN 37076-2169
(615) 600-5107
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/12/2025
Last updated
09/12/2025
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