Provider Demographics
NPI:1649158734
Name:MCDOLE, MALCOLM
Entity type:Individual
Prefix:
First Name:MALCOLM
Middle Name:
Last Name:MCDOLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MALCOLM
Other - Middle Name:
Other - Last Name:MCDOLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3035 GEORGE BUCHANAN DR
Mailing Address - Street 2:
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086-3281
Mailing Address - Country:US
Mailing Address - Phone:615-305-5320
Mailing Address - Fax:
Practice Address - Street 1:762 E ARGYLE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5024
Practice Address - Country:US
Practice Address - Phone:615-988-6413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health