| Doctor Name: | DR. PHILLIP L. BLANSETT |
| NPI Number: | 1164679957 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | LPC654 |
| Business Practice Address: | 1621 Eagle Trace Dr Mount Juliet, TN - 371227428 |
| Business Phone Number: | 6157583810 |
| Business Fax Number: | 2533224905 |
| Mailing Address: | 1621 Eagle Trace Dr, MOUNT JULIET |
| State: | TN |
| Postal Code: | 371227428 |
| Phone Number: | 6157583810 |
| Fax Number: | 2533224905 |
| NPI Enumeration Date: | 08/22/2008 |
| NPI Last Update Date: | 08/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC654 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |