Corum, Kevin Scott

Corum, Kevin Scott is an sole proprietor health care provider with primary practice located at 210 Simmons St , Maryville TN 37801-4750. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Corum, Kevin Scott can be contacted via phone (865) 970-9800.

Contact Information

Primary practice address
210 Simmons St Maryville TN 37801-4750
Fax: (865) 983-4518
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4705 Tennessee

Profile Details

NPI number 1316945504
LBN Legal business name Corum, Kevin Scott
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2005
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316945504 NPPES
Tennessee MEDICAID Q031992

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