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Contact Information

SOUTHERN ANGELS COMPREHENSIVE SUPPORT GROUP LLC
4243 LEBANON PIKE STE C
HERMITAGE, TN37076-2170
 Phone: 615-600-5107
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
 

Behavior Analyst

103K00000X
 

Case Manager/Care Coordinator

171M00000X
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
 

Professional

101YP2500X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for SOUTHERN ANGELS COMPREHENSIVE SUPPORT GROUP LLC · (Female)

NPI Number 1467323592
Status Active
Credentials
Entity Individual
Enumeration date 09/12/2025
Last updated 09/12/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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