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General NPI Number Information
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NPI Number | 1932352218
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Entity Type | Organization
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Legal Business Name | CHILD & FAMILY TENNESSEE
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 2601 KEITH AVE
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City | KNOXVILLE
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State | TN
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Zip | 37921-5649
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Country | US
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Telephone | 865-521-1312
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Fax | 865-521-5632
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Provider Business Mailing Address
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Address Line | 901 E SUMMIT HILL DR
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City | KNOXVILLE
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State | TN
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Zip | 37915-1200
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Country | US
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Telephone | 865-524-7483
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | BARBARA ANN STANDRIDGE
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Credential | LCSW
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Telephone | 865-524-7483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LSW0000001058
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License Number State | TN
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