Healthcare Provider Details

I. General information

NPI: 1346019494
Provider Name (Legal Business Name): KASEY LEE DILLINGHAM LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 BRIARCLIFF AVE
OAK RIDGE TN
37830-8743
US

IV. Provider business mailing address

850 BRIARCLIFF AVE
OAK RIDGE TN
37830-8743
US

V. Phone/Fax

Practice location:
  • Phone: 865-483-3172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number15399
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: