MEDICARE: MRS. TAMARA SHARON JOHNSON 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	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	6935	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396860086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMARA SHARON JOHNSON LCSW

Provider Business Mailing Address
First Line	:	221 LANCASTER DR
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-6808
Country	:	US
Telephone Number	:	865-970-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 PROSPERITY DR STE 206
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4718
Country	:	US
Telephone Number	:	865-317-4244
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	08/09/2020

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