| Dogwood Psychological Services Of East Tennessee | |
|
415 E Unaka Ave Johnson City TN 37601-4030 | |
| (423) 364-2972 | |
| Not Available |
| Full Name | Dogwood Psychological Services Of East Tennessee |
|---|---|
| Speciality | Psychologist |
| Location | 415 E Unaka Ave, Johnson City, Tennessee |
| Authorized Official Name and Position | Holly Skinner (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5014641664 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dogwood Psychological Services Of East Tennessee 415 E Unaka Ave Johnson City TN 37601-4030 Ph: () - | Dogwood Psychological Services Of East Tennessee 415 E Unaka Ave Johnson City TN 37601-4030 Ph: (423) 364-2972 |
| NPI Number | 1427812411 |
|---|---|
| Provider Enumeration Date | 02/09/2024 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Medicare PECOS PAC ID | 9133661697 |
|---|---|
| Medicare Enrollment ID | O20240612000953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427812411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bess Summerlin Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184232605 PECOS PAC ID: 9436501822 Enrollment ID: I20240612000892 |
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