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General NPI Number Information
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NPI Number | 1376569988
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Entity Type | Individual
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Provider Name | MARK S. KRYTER LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 10434 JACKSON OAKS WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-3293
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Country | US
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Telephone | 865-730-4171
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Fax | 423-388-4774
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Provider Business Mailing Address
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Address Line | 10434 JACKSON OAKS WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-3293
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Country | US
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Telephone | 865-281-1408
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Fax | 865-244-3579
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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 | LCSW0000003149
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License Number State | TN
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