Basic Information
Provider Information
NPI: 1982883286
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ACORD
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 201 W SPRINGDALE AVE
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379175158
CountryCode: US
TelephoneNumber: 8656379711
FaxNumber: 8655416941
Practice Location
Address1: 201 W SPRINGDALE AVE
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379175158
CountryCode: US
TelephoneNumber: 8656379711
FaxNumber: 8655416941
Other Information
ProviderEnumerationDate: 11/02/2007
LastUpdateDate: 09/26/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X5406TNY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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