Healthcare Provider Details

I. General information

NPI: 1255964169
Provider Name (Legal Business Name): MARIE CARVER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 GLENWOOD DR STE E786
CHATTANOOGA TN
37404-1192
US

IV. Provider business mailing address

1949 GUNBARREL RD STE 206
CHATTANOOGA TN
37421-7133
US

V. Phone/Fax

Practice location:
  • Phone: 423-682-8150
  • Fax: 423-495-4819
Mailing address:
  • Phone: 423-495-4345
  • Fax: 423-495-4934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10365
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: