Provider Demographics
NPI:1447495544
Name:WAHLER, NANCY GRAVES (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:GRAVES
Last Name:WAHLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5116 GRAYSTONE LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-8646
Mailing Address - Country:US
Mailing Address - Phone:865-405-9919
Mailing Address - Fax:
Practice Address - Street 1:5959 SHALLOWFORD RD STE 429-4
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2289
Practice Address - Country:US
Practice Address - Phone:865-405-9919
Practice Address - Fax:866-209-4029
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000041281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical