Provider Demographics
NPI:1144803925
Name:MINTON FAMILY THERAPY, PLLC
Entity Type:Organization
Organization Name:MINTON FAMILY THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:865-385-3467
Mailing Address - Street 1:3031 CONNER DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2427
Mailing Address - Country:US
Mailing Address - Phone:865-219-3352
Mailing Address - Fax:
Practice Address - Street 1:407 N FOREST PARK BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5136
Practice Address - Country:US
Practice Address - Phone:865-219-3352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1518476373OtherNPI
1942770821OtherNPI