Healthcare Provider Details

I. General information

NPI: 1366375818
Provider Name (Legal Business Name): SMOKY MOUNTAIN MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E MACON LN
SEYMOUR TN
37865-4749
US

IV. Provider business mailing address

130 E MACON LN
SEYMOUR TN
37865-4749
US

V. Phone/Fax

Practice location:
  • Phone: 865-378-7723
  • Fax: 865-270-4578
Mailing address:
  • Phone: 865-378-7723
  • Fax: 865-270-4578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMY SEAL
Title or Position: OWNER, PRESIDENT
Credential: PMHNP
Phone: 865-378-7723