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General NPI Number Information
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NPI Number | 1407704679
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Entity Type | Individual
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Provider Name | SUE ELLEN SILCOX
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Gender | Female
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Dates
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Enumeration Date | 03/21/2026
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Last Update Date | 03/21/2026
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Provider Practice Location Address
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Address Line | 4726 AIRPORT HWY
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City | LOUISVILLE
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State | TN
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Zip | 37777-5402
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Country | US
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Telephone | 865-970-7747
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Fax | 865-862-0639
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Provider Business Mailing Address
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Address Line | 1643 DORA ST
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City | KNOXVILLE
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State | TN
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Zip | 37921-4810
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Country | US
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Telephone | 423-437-7618
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Fax | 865-862-0639
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1534
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License Number State | TN
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