Individual
TAMMIE RENEE CRECELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
228 W MAIN ST, SUITE B, LEBANON, TN 37087-2744
(615) 830-2166
(615) 453-9697
Mailing address
228 W MAIN ST, SUITE B, LEBANON, TN 37087-2744
(615) 830-2166
(615) 895-7903
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW0000004196
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW0000004196
STATE LISCENSE
TN
Enumeration date
05/15/2007
Last updated
06/11/2008
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