Provider Demographics
NPI:1306143508
Name:STANFIELD, MICHAEL V (DMIN, LMFT)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:V
Last Name:STANFIELD
Suffix:
Gender:M
Credentials:DMIN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 KEOWEE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7711
Mailing Address - Country:US
Mailing Address - Phone:865-522-9804
Mailing Address - Fax:865-523-9446
Practice Address - Street 1:3700 KEOWEE AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-7711
Practice Address - Country:US
Practice Address - Phone:865-522-9804
Practice Address - Fax:865-523-9446
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLMT0000000338106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist