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Individual

KEITH NILSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LPC, MHSP, NCC

Contact information

Practice address
801 N HOLTZCLAW AVE, CHATTANOOGA, TN 37404-1236
(423) 697-5985
(423) 697-5999
Mailing address
275 CUMBERLAND BND, NASHVILLE, TN 37228-1805
(931) 349-4533
(423) 728-6449

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
3840
NC
101YP2500X
Professional Counselor
Primary
3734
TN

Other

Enumeration date
06/04/2009
Last updated
01/24/2017
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