Active NPI
Southern Angels Comprehensive Support Group LLC
- Speech-Language Pathologist
- Hermitage, TN
National Provider Identifier
1467323592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- SOUTHERN ANGELS COMPREHENSIVE SUPPORT GROUP LLC
- Practice address
- 4243 Lebanon Pike Ste C
Hermitage, TN 37076-2170 - Phone
- (615) 600-5107
- NPI assigned
- Sep 12, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Vanna M. Anderson
- Title
- Owener/Ceo
- Phone
- (615) 657-9123
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Behavior Analyst | 103K00000X | |||
| Psychologist | 103T00000X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
4243 Lebanon Pike Ste C
Hermitage, TN 37076-2170
Mailing address
4243 Lebanon Pike Ste C
Hermitage, TN 37076-2169
Phone (615) 600-5107
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757635200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757635200000",
"number": "1467323592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4243 LEBANON PIKE STE C",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "370762169",
"telephone_number": "615-600-5107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4243 LEBANON PIKE STE C",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "370762170",
"telephone_number": "615-600-5107"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN ANGELS COMPREHENSIVE SUPPORT GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-09-12",
"last_updated": "2025-09-12",
"certification_date": "2025-09-12",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "VANNA",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "OWENER/CEO",
"authorized_official_telephone_number": "615-657-9123",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hermitage, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.