Mcbride, Mitzi Suzanne

Mcbride, Mitzi Suzanne is an individual health care provider with primary practice located at 119 Pedigo Road Suite F, Madisonville TN 37354. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mcbride, Mitzi Suzanne can be contacted via phone (423) 442-5280.

Contact Information

Primary practice address
119 Pedigo Road Suite F Madisonville TN 37354
Phone: (423) 442-5280
Fax: (423) 442-8127
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW6249 Tennessee
Behavioral Health & Social Service Providers / Clinical 1041C0700X LSW4740 Tennessee

Profile Details

NPI number 1720086929
LBN Legal business name Mcbride, Mitzi Suzanne
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Jul 8th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720086929 NPPES
Tennessee MEDICAID 3987500

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