Provider Demographics
NPI:1316084320
Name:KONTOVICH, LINDSEY POWELL (MED)
Entity type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:POWELL
Last Name:KONTOVICH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W SUMMIT HILL DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902-1025
Mailing Address - Country:US
Mailing Address - Phone:865-525-7494
Mailing Address - Fax:865-525-7494
Practice Address - Street 1:108 W SUMMIT HILL DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37902-1025
Practice Address - Country:US
Practice Address - Phone:865-525-1099
Practice Address - Fax:865-525-7494
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2933101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional