Healthcare Provider Details

I. General information

NPI: 1104536598
Provider Name (Legal Business Name): BIANCA MASSI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10608 FLICKENGER LN
KNOXVILLE TN
37922-3485
US

IV. Provider business mailing address

10608 FLICKENGER LN
KNOXVILLE TN
37922-3485
US

V. Phone/Fax

Practice location:
  • Phone: 833-917-3400
  • Fax: 866-308-4392
Mailing address:
  • Phone: 833-917-3400
  • Fax: 866-308-4392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23351
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: