Individual
KEVIN SCOTT CORUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
210 SIMMONS ST, MARYVILLE, TN 37801-4750
(865) 970-9800
(865) 983-4518
Mailing address
2334 BOB CARNES RD, KNOXVILLE, TN 37924-1801
(865) 964-5882
(865) 689-4443
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4705
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q031992
—
TN
Enumeration date
07/12/2005
Last updated
03/17/2018
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