Healthcare Provider Details

I. General information

NPI: 1255461059
Provider Name (Legal Business Name): PATRICIA LYNN PROCTOR M.ED., LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRISH HORNER M.ED., LPC-MHSP

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 03/06/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6305 LONAS DR
KNOXVILLE TN
37909-3767
US

IV. Provider business mailing address

6305 LONAS DR
KNOXVILLE TN
37909-3767
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-3173
  • Fax: 423-763-4657
Mailing address:
  • Phone: 865-588-3173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number02546
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2546
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: