MEDICARE: AMY L PEELER 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
1	104100000X	Social Worker	CSW7002	TN
2	1041C0700X	Clinical Social Worker	7002	TN
3	1041C0700X	Clinical Social Worker	3730	HI
4	1041C0700X	Clinical Social Worker	5204	TN

General Provider Information

NPI Number	:	1487710034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY L PEELER LCSW

Provider Business Mailing Address
First Line	:	1451 DOWELL SPRINGS BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2441
Country	:	US
Telephone Number	:	865-374-7123
Fax Number	:	865-374-7129

Provider Business Practice Location Address
First Line	:	210 SIMMONS ST
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37801-4750
Country	:	US
Telephone Number	:	865-970-9800
Fax Number	:	865-374-7129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	12/12/2013

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Directions to “ AMY L PEELER LCSW” Practice Location

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