Basic Information
| Provider Information | |||||||||
| NPI: | 1881172922 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWEENEY | ||||||||
| FirstName: | ELISABETH | ||||||||
| MiddleName: | QUINTRELL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1112 INGLEWOOD DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372161426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047310598 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2209 ABBOTT MARTIN RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6155198960 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2018 | ||||||||
| LastUpdateDate: | 04/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC2200X | 3558 | TN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No ID Information.