Provider Demographics
NPI:1144056177
Name:DEBERRY, JUSTINA (LPC-MHSP(T))
Entity type:Individual
Prefix:
First Name:JUSTINA
Middle Name:
Last Name:DEBERRY
Suffix:
Gender:F
Credentials:LPC-MHSP(T)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6688 NOLENSVILLE RD
Mailing Address - Street 2:STE 108 #2023
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-398-1632
Mailing Address - Fax:
Practice Address - Street 1:1 VANTAGE WAY STE E130
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1591
Practice Address - Country:US
Practice Address - Phone:615-398-1632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTEMP101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health