Individual
MR. RONALD WAYNE LAUDERDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSSW
Contact information
Practice address
5117 SCHUBERT RD STE #A, CHRISTIAN COUNSELING CENTER, KNOXVILLE, TN 37912-3871
(865) 689-3326
(865) 689-3326
Mailing address
1104 WEST ADAIR DR, KNOXVILLE, TN 37918-1527
(865) 688-3326
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4847
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138577
VALUE OPTIMA
TN
05
—
197473293284
—
TN
01
—
3101178
BC BST
TN
01
—
5694663
AETNA
TN
01
—
737240000
MAGELLAN
TN
Enumeration date
04/23/2007
Last updated
07/09/2008
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