| Family Dynamics Behavioral Health Llc | |
|
318 N Forest Park Blvd Knoxville TN 37919-5127 | |
| (865) 806-0566 | |
| Not Available |
| Full Name | Family Dynamics Behavioral Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 318 N Forest Park Blvd, Knoxville, Tennessee |
| Authorized Official Name and Position | Chenoa Y Shenandoah (OWNER) |
| Authorized Official Contact | 8652632200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dynamics Behavioral Health Llc 318 N Forest Park Blvd Knoxville TN 37919-5127 Ph: (865) 263-2200 | Family Dynamics Behavioral Health Llc 318 N Forest Park Blvd Knoxville TN 37919-5127 Ph: (865) 806-0566 |
| NPI Number | 1295467462 |
|---|---|
| Provider Enumeration Date | 06/27/2022 |
| Last Update Date | 09/20/2022 |
| Certification Date | 09/16/2022 |
| Medicare PECOS PAC ID | 5294199857 |
|---|---|
| Medicare Enrollment ID | O20230914002688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295467462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Chenoa Y Shenandoah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154761542 PECOS PAC ID: 9133363740 Enrollment ID: I20130923000216 |
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