Provider Demographics
NPI:1255521662
Name:DAVIS, ANDREA JEAN (LPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:JEAN
Other - Last Name:JESSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:319 ROSEMARY ST
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5260
Mailing Address - Country:US
Mailing Address - Phone:615-542-0347
Mailing Address - Fax:
Practice Address - Street 1:3310 PERIMETER HILL DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4123
Practice Address - Country:US
Practice Address - Phone:615-250-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN3533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health