Provider Demographics
NPI:1871900993
Name:HONEYCUTT, CHARLES TIMOTHY (MA, LPE)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:TIMOTHY
Last Name:HONEYCUTT
Suffix:
Gender:M
Credentials:MA, LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-4103
Mailing Address - Country:US
Mailing Address - Phone:615-244-4802
Mailing Address - Fax:
Practice Address - Street 1:319 S 4TH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-4103
Practice Address - Country:US
Practice Address - Phone:615-244-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000011626103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist