Individual
MR. THOMAS RUSSELL HUMBERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LPC MHSP
Contact information
Practice address
5410 HOMBERG DRIVE, STE 14, KNOXVILLE, TN 37919
(865) 588-3173
(865) 588-3174
Mailing address
5410 HOMBERG DRIVE, STE 14, KNOXVILLE, TN 37919
(865) 588-3173
(865) 588-3174
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC0000001609
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1220955
CHA HEALTH
—
01
—
244504
COMPSYCH
—
01
—
359710
MANAGED HEALTH NETWORK
—
01
—
4105431
BLUE CROSS BLUE SHIELD
—
01
—
9375370
PRINCIPLE GROUP LIFE
—
01
—
TN0104
JOHN DEERE HEALTH
—
Enumeration date
08/02/2006
Last updated
07/08/2007
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