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General NPI Number Information
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NPI Number | 1497729701
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Entity Type | Individual
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Provider Name | JOHN TYLER OVERSTREET LSPE, LPC
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 111 CENTER PARK DR SUITE 1300
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City | KNOXVILLE
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State | TN
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Zip | 37922-2103
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Country | US
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Telephone | 865-693-9997
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 966
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City | KINGSTON
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State | TN
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Zip | 37763-0966
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Country | US
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Telephone | 865-376-9879
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Fax | 865-717-2777
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC422
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PE1317
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License Number State | TN
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