Provider Demographics
NPI:1164763751
Name:VOLUNTEER PSYCHIATRIC CONSULTANTS, INC.
Entity Type:Organization
Organization Name:VOLUNTEER PSYCHIATRIC CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:MATHEWSON
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:865-531-9129
Mailing Address - Street 1:9040 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 234
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4640
Mailing Address - Country:US
Mailing Address - Phone:865-531-9129
Mailing Address - Fax:888-843-7657
Practice Address - Street 1:9040 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 234
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4640
Practice Address - Country:US
Practice Address - Phone:865-531-9129
Practice Address - Fax:888-843-7657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10492363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3648105OtherMEDICARE TYPE UNSPECIFIED