Individual
GARY MASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
105 W STONE DR, STE 3B, KINGSPORT, TN 37660-3256
(423) 578-1541
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW03239
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008907528
—
VA
05
—
3695900
—
TN
Enumeration date
06/09/2005
Last updated
09/22/2009
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