Provider Demographics
NPI:1124547781
Name:JAMES, THERESA HELEN (MSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:HELEN
Last Name:JAMES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:HELEN
Other - Last Name:ROMARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:9111 CROSS PARK DR STE E475
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4533
Mailing Address - Country:US
Mailing Address - Phone:865-560-2550
Mailing Address - Fax:
Practice Address - Street 1:448 NEAL ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4027
Practice Address - Country:US
Practice Address - Phone:931-525-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1041CO700XMedicaid