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162d Market Place Blvd Knoxville TN 37922-2337 | |
| (865) 212-6600 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 162d Market Place Blvd, Knoxville, Tennessee |
| Authorized Official Name and Position | Virginia Marie Steelman (SECRETARY) |
| Authorized Official Contact | 7045066267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (865) 212-6600 | 162d Market Place Blvd Knoxville TN 37922-2337 Ph: (865) 212-6600 |
| NPI Number | 1083480081 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 05/29/2024 |
| Certification Date | 05/29/2024 |
| Medicare PECOS PAC ID | 5092120030 |
|---|---|
| Medicare Enrollment ID | O20240813003368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083480081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Paul Dcruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558361493 PECOS PAC ID: 0345210167 Enrollment ID: I20040729000270 |
| Provider Name | Karen L Moyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154384097 PECOS PAC ID: 5799700829 Enrollment ID: I20051007000737 |
| Provider Name | Nancy C Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760632939 PECOS PAC ID: 8022177419 Enrollment ID: I20090128000373 |
| Provider Name | Kathryn J Nottingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376963181 PECOS PAC ID: 3678892692 Enrollment ID: I20150424001020 |
| Provider Name | Beckey Buck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033585930 PECOS PAC ID: 9032410337 Enrollment ID: I20151210000772 |
| Provider Name | Hannah K Stockton Hutchins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235618414 PECOS PAC ID: 2163772070 Enrollment ID: I20180913001118 |
| Provider Name | Amber Fortenberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548681935 PECOS PAC ID: 7214269026 Enrollment ID: I20191029000279 |
| Provider Name | Yvonne L Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033750914 PECOS PAC ID: 5890129001 Enrollment ID: I20191221000338 |
| Provider Name | Bryce Douglas Nolen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154026037 PECOS PAC ID: 3678910742 Enrollment ID: I20240325002871 |
| Provider Name | Lori Boudreaux |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720292337 PECOS PAC ID: 5193164564 Enrollment ID: I20240417004065 |
| Provider Name | Caroline Russe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285223792 PECOS PAC ID: 4981045929 Enrollment ID: I20240508003190 |
| Provider Name | Emily Clifton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548018153 PECOS PAC ID: 5890230189 Enrollment ID: I20240710005095 |
| Provider Name | Paul Bradley Watts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649739863 PECOS PAC ID: 9739624412 Enrollment ID: I20240717004320 |
| Provider Name | Clyde Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588242416 PECOS PAC ID: 6204369994 Enrollment ID: I20241104000142 |
Lane M. Cook, M.d. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4428 Sutherland Ave, Knoxville, TN 37919 Phone: 865-588-6425 Fax: 865-584-8066 | |
David Friend, Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9631 W Emory Rd., Knoxville, TN 37931 Phone: 865-219-9559 | |
Omega Pain Management, Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6348 Lonas Spring Dr, Knoxville, TN 37909 Phone: 865-337-5137 Fax: 888-839-6922 | |
The Next Door Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2636 Maryville Pike, Knoxville, TN 37920 Phone: 865-934-2890 Fax: 865-934-2894 | |
Mckinnon Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6626 Central Avenue Pike, Knoxville, TN 37912 Phone: 865-235-9742 | |
Rha Health Services Tn Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9041 Executive Park Dr Ste 705, Knoxville, TN 37923 Phone: 895-769-7491 | |
Weatherstone Collaborative Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 323 Ebenezer Rd, Knoxville, TN 37923 Phone: 865-272-9709 |