Provider Demographics
NPI:1902869431
Name:MONROE, THOMAS CORNELIUS III (PSYD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CORNELIUS
Last Name:MONROE
Suffix:III
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 MURPHY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1835
Mailing Address - Country:US
Mailing Address - Phone:615-329-0501
Mailing Address - Fax:
Practice Address - Street 1:2201 MURPHY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1835
Practice Address - Country:US
Practice Address - Phone:615-329-0501
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2145103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3981764Medicare ID - Type Unspecified