Provider Demographics
NPI:1992984538
Name:WHARTON, MELANIE R (LCSW)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:R
Last Name:WHARTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53302
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-3302
Mailing Address - Country:US
Mailing Address - Phone:865-352-9444
Mailing Address - Fax:865-690-0995
Practice Address - Street 1:301 S GALLAHER VIEW RD STE 224
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5361
Practice Address - Country:US
Practice Address - Phone:865-227-7489
Practice Address - Fax:865-690-0995
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6738171M00000X
TNLSW00000049681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4312388OtherBCBS
TN12337629OtherCAQH