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NPI Code Detail

MEDICARE: MARK S. KRYTER LCSW

MEDICARE: MARK S. KRYTER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW0000003149TN

General Provider Information

NPI Number : 1376569988
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK S. KRYTER LCSW
Provider Business Mailing Address
First Line : 10434 JACKSON OAKS WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-3293
Country : US
Telephone Number : 865-281-1408
Fax Number : 865-244-3579
Provider Business Practice Location Address
First Line : 10434 JACKSON OAKS WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-3293
Country : US
Telephone Number : 865-730-4171
Fax Number : 423-388-4774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 07/16/2021

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