Provider Demographics
NPI:1427442151
Name:BLOUNT COUNTY CHILDREN'S ADVOCACY CENTER
Entity type:Organization
Organization Name:BLOUNT COUNTY CHILDREN'S ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAMRON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:865-981-2000
Mailing Address - Street 1:212 CATES ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-4902
Mailing Address - Country:US
Mailing Address - Phone:865-981-2000
Mailing Address - Fax:
Practice Address - Street 1:212 CATES ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4902
Practice Address - Country:US
Practice Address - Phone:865-981-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty