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836 W 1st North St Morristown TN 37814-4548 | |
| (423) 616-0213 | |
| (865) 381-0521 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 836 W 1st North St, Morristown, Tennessee |
| Authorized Official Name and Position | William Butler (BUSINESS MANAGER) |
| Authorized Official Contact | 8653066362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
836 W 1st North St # 103 Morristown TN 37814-4548 Ph: (423) 616-0213 | 836 W 1st North St Morristown TN 37814-4548 Ph: (423) 616-0213 |
| NPI Number | 1982044095 |
|---|---|
| Provider Enumeration Date | 07/03/2013 |
| Last Update Date | 01/10/2025 |
| Certification Date | 01/10/2025 |
| Medicare PECOS PAC ID | 4385926534 |
|---|---|
| Medicare Enrollment ID | O20190506002089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982044095 | NPI | - | NPPES |
| Provider Name | Daniel J Luke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174636542 PECOS PAC ID: 8820056435 Enrollment ID: I20041229000683 |
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