MEDICARE: TONYA KATHLEEN COMER LCSW

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	1041C0700X	Clinical Social Worker	6790	TN
2	1041C0700X	Clinical Social Worker	CSW6790	TN
3	1041C0700X	Clinical Social Worker	TN5057	TN
4	1041C0700X	Clinical Social Worker	LSW5057	TN

General Provider Information

NPI Number	:	1164493938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA KATHLEEN COMER LCSW

Provider Business Mailing Address
First Line	:	2900 TAZEWELL PIKE STE G
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1880
Country	:	US
Telephone Number	:	865-689-4421
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 TAZEWELL PIKE STE G
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1880
Country	:	US
Telephone Number	:	865-689-4421
Fax Number	:

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	06/09/2019

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