Individual
MRS. MARY LUGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3105 ESSARY DR, KNOXVILLE, TN 37918-2409
(865) 687-8990
(865) 687-1190
Mailing address
3105 ESSARY DRIVE, KNOXVILLE, TN 37918
(865) 687-8990
(865) 687-1190
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904007694
VA
1041C0700X
Clinical Social Worker
Primary
5913
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I806846
MEDICARE
TN
05
—
1730458639
—
VA
05
—
Q001974
—
TN
01
—
Q38872A
MEDICARE
VA
Enumeration date
12/21/2011
Last updated
04/08/2014
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