Individual
STEPHEN BRADLEY JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
816 E OLDHAM AVE, KNOXVILLE, TN 37917-5567
(865) 300-0636
Mailing address
816 E OLDHAM AVE, KNOXVILLE, TN 37917-5567
(865) 300-0636
(865) 525-2958
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10820
TN
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
8492
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q081583
—
TN
Enumeration date
10/05/2012
Last updated
04/04/2024
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