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NPI Code Detail

MEDICARE: LEASA SATTERFIELD GRAHAM LCSW

MEDICARE: LEASA SATTERFIELD GRAHAM 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
11041C0700XClinical Social WorkerCSW6212TN
21041C0700XClinical Social WorkerLSW4707TN

General Provider Information

NPI Number : 1841299294
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEASA SATTERFIELD GRAHAM LCSW
Provider Business Mailing Address
First Line : 6350 W A J HWY
Second Line : DEPARTMENT 100
City : TALBOTT
State : TN
Zip : 37877
Country : US
Telephone Number : 800-355-3565
Fax Number : 423-714-2355
Provider Business Practice Location Address
First Line : 815 W 5TH NORTH ST
Second Line :
City : MORRISTOWN
State : TN
Zip : 37814-3810
Country : US
Telephone Number : 423-586-5032
Fax Number : 423-581-8473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 08/23/2010

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