MEDICARE: SUMMER DAYS THERAPY LLC

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

General Provider Information

NPI Number	:	1922962125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMER DAYS THERAPY LLC

Provider Business Mailing Address
First Line	:	1201 N WILCOX DR STE C
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37660-4986
Country	:	US
Telephone Number	:	423-218-9214
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 N WILCOX DR STE C
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37660-4986
Country	:	US
Telephone Number	:	423-218-9214
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	SUMMER AHMED
Credential	:	LCSW
Telephone Number	:	423-218-9214

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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