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General NPI Number Information
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NPI Number | 1073266656
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Entity Type | Individual
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Provider Name | KHRISTAN DEICHERT CIMINO
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Gender | Female
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 9129 CROSS PARK DR STE 100
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City | KNOXVILLE
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State | TN
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Zip | 37923-4505
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Country | US
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Telephone | 865-983-2899
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Fax | 865-409-5948
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Provider Business Mailing Address
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Address Line | 9129 CROSS PARK DR STE 100
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City | KNOXVILLE
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State | TN
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Zip | 37923-4505
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Country | US
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Telephone | 865-983-2899
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Fax | 865-409-5948
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9872
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 259675
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License Number State | KY
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