Individual
DOMONIQUE DESHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LPCMH, LMSW
Contact information
Practice address
500 28TH AVE N STE 210, NASHVILLE, TN 37209-4456
(615) 208-2908
Mailing address
514 GILROY CT, ANTIOCH, TN 37013-8906
(302) 353-2604
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC-0011050
DE
101YP2500X
Professional Counselor
Primary
7305
TN
101YP2500X
Professional Counselor
9542
LA
Other
Enumeration date
09/15/2019
Last updated
07/18/2025
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