MEDICARE: MS. BIANCA MASSI LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor
3	101YM0800X	Mental Health Counselor	MH23351	FL

General Provider Information

NPI Number	:	1104536598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BIANCA MASSI LMHC

Provider Business Mailing Address
First Line	:	10608 FLICKENGER LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3485
Country	:	US
Telephone Number	:	833-917-3400
Fax Number	:	866-308-4392

Provider Business Practice Location Address
First Line	:	10608 FLICKENGER LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3485
Country	:	US
Telephone Number	:	833-917-3400
Fax Number	:	866-308-4392

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	02/21/2025

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