Fain, Walter Worley
Fain, Walter Worley is an sole proprietor health care provider with primary practice located at 659 Morganton Square Dr , Maryville TN 37801-4763. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fain, Walter Worley can be contacted via phone (865) 983-3348.Contact Information
Primary practice address
659 Morganton Square Dr
Maryville TN 37801-4763
Phone: (865) 983-3348
Fax: (615) 296-4440
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | P0000001139 | Tennessee |
Profile Details
| NPI number | 1972589638 |
|---|---|
| LBN Legal business name | Fain, Walter Worley |
| Credentials | ED.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 15th, 2005 |
| Last updated | Feb 2nd, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972589638 | NPPES |
| Tennessee | Other | 2004080 | BLUE CROSS NUMBER |
| Tennessee | Other | 62-1424098-379200000 | BLUE CROSS NUMBER |
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