Organization
4C THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIBBY LORD REDFIELD LCSW (OWNER)
(865) 288-2112
Entity
Organization
Contact information
Practice address
111 CENTER PARK DR STE 900, KNOXVILLE, TN 37922-2133
(865) 288-2112
Mailing address
12749 HEATHLAND DR, KNOXVILLE, TN 37934-4442
(865) 386-6339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4482
CASH BASE AGENCY
TN
Enumeration date
03/05/2022
Last updated
03/05/2022
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