Provider Demographics
NPI:1073582334
Name:WARNER, PATRICIA DAVIS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:DAVIS
Last Name:WARNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 CAPRI DR.
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912
Mailing Address - Country:US
Mailing Address - Phone:865-247-6385
Mailing Address - Fax:865-314-8404
Practice Address - Street 1:6824 TICE LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-5240
Practice Address - Country:US
Practice Address - Phone:865-247-6385
Practice Address - Fax:865-314-8404
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4529104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522084Medicaid
TN3989628OtherMEDICARE NUMBER
TN1522084Medicaid