Provider Demographics
NPI:1861805665
Name:JAMISON, PAUL ROBERT (LPC-MHSP)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ROBERT
Last Name:JAMISON
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 TERRY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1307
Mailing Address - Country:US
Mailing Address - Phone:781-718-6862
Mailing Address - Fax:
Practice Address - Street 1:6120 TERRY DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1307
Practice Address - Country:US
Practice Address - Phone:781-718-6862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator