Individual
REBEKKAH M WITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
550 SUNSET TRL, JELLICO, TN 37762-2343
(423) 784-5771
(423) 784-6185
Mailing address
107 S MAIN ST, JELLICO, TN 37762-2154
(423) 784-8492
(423) 455-0380
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
4039
KY
1041C0700X
Clinical Social Worker
Primary
6849
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4039
STATE LICENSE
KY
01
—
6849
STATE LICENSE
TN
05
—
7100348420
—
KY
05
—
Q047576
—
TN
Enumeration date
01/29/2013
Last updated
05/10/2022
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