Provider Demographics
NPI:1548921505
Name:MCNEILLY, PAIGE (TLMFT)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:MCNEILLY
Suffix:
Gender:F
Credentials:TLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 PATTERSON ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2177
Mailing Address - Country:US
Mailing Address - Phone:901-603-6563
Mailing Address - Fax:
Practice Address - Street 1:1916 PATTERSON ST STE 700
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2177
Practice Address - Country:US
Practice Address - Phone:901-603-6563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1801106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR75009OtherCPH & ASSOCIATES