Nashville Psychedelic Center, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NASHVILLE PSYCHEDELIC CENTER, LLC

Practice address

1007 Towee CT
Kingston Springs, TN 37082-5171

Phone

(865) 617-5110

NPI assigned

Aug 24, 2022

Last updated

Aug 24, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert DesalvoNPI 1801165675

Title

Co-Owner

Phone

(155) 608-7426

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Desalvo

  • Clinical Social Worker
  • Murfreesboro, TN
  • NPI 1801165675
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1245959188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 TOWEE CT",
            "city": "KINGSTON SPRINGS",
            "state": "TN",
            "postal_code": "370825171",
            "telephone_number": "865-617-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 TOWEE CT",
            "city": "KINGSTON SPRINGS",
            "state": "TN",
            "postal_code": "370825171",
            "telephone_number": "865-617-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASHVILLE PSYCHEDELIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "DESALVO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "155-608-7426",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Kingston Springs, TN
• Providers in Kingston Springs, TN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.