Individual
JARED PRENTISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
5320 HICKORY HOLLOW PKWY, ANTIOCH, TN 37013-3128
(615) 669-5605
Mailing address
1091 SECRETARIAT DR, MT JULIET, TN 37122-3568
(615) 669-5605
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2904
TN
101YP2500X
Professional Counselor
Primary
2904
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q014226
—
TN
Enumeration date
02/16/2015
Last updated
03/24/2018
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