Provider Demographics
NPI:1730237983
Name:CORNETT, CARLTON WAYNE (MSW)
Entity type:Individual
Prefix:MR
First Name:CARLTON
Middle Name:WAYNE
Last Name:CORNETT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 W END AVE
Mailing Address - Street 2:SUITE # 208
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1453
Mailing Address - Country:US
Mailing Address - Phone:615-329-9509
Mailing Address - Fax:
Practice Address - Street 1:2817 W END AVE
Practice Address - Street 2:SUITE # 208
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1453
Practice Address - Country:US
Practice Address - Phone:615-329-9509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000008701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical