Provider Demographics
NPI:1730740028
Name:ANDERSON, CAROLINE GOUDELOCK (MMFT)
Entity type:Individual
Prefix:MISS
First Name:CAROLINE
Middle Name:GOUDELOCK
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 DIVISION ST STE 405
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-4495
Mailing Address - Country:US
Mailing Address - Phone:615-274-8400
Mailing Address - Fax:
Practice Address - Street 1:1200 DIVISION ST STE 405
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-4495
Practice Address - Country:US
Practice Address - Phone:615-274-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health