MEDICARE: MS. PATRICIA ABBARNO 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	1041C0700X	Clinical Social Worker	759	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16615400	OTHER	TN	MAGELLAN PROVIDER ID
2	159137	OTHER	TN	VALUE OPTIONS PROVIDER ID
3	3089453	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1609878198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ABBARNO LCSW

Provider Business Mailing Address
First Line	:	111 CENTER PARK DR
Second Line	:	SUITE 1300
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-2124
Country	:	US
Telephone Number	:	865-693-9997
Fax Number	:	865-531-0994

Provider Business Practice Location Address
First Line	:	111 CENTER PARK DR
Second Line	:	SUITE 1300
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-2124
Country	:	US
Telephone Number	:	865-693-9997
Fax Number	:	865-531-0994

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	02/22/2008

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