Individual
MRS. SHANNAN LEIGH BERNTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2141 OLD ASHLAND CITY RD, CLARKSVILLE, TN 37043
(931) 553-8500
(931) 553-8544
Mailing address
3345 CHAPEL HILL RD, CLARKSVILLE, TN 37040-8204
(928) 580-0609
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
6221
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q027454
—
TN
Enumeration date
06/03/2012
Last updated
09/04/2018
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