Provider Demographics
NPI:1487797379
Name:KROMER, MELANIE CHARMAINE (LPC)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:CHARMAINE
Last Name:KROMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4452 S TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-4202
Mailing Address - Country:US
Mailing Address - Phone:615-847-0027
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:615-250-7264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1808OtherLICENSE