Provider Demographics
NPI:1194036640
Name:SPURGEON, SHAWN LAMONT (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:LAMONT
Last Name:SPURGEON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 CORDOBA RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-1411
Mailing Address - Country:US
Mailing Address - Phone:865-951-0523
Mailing Address - Fax:865-974-5629
Practice Address - Street 1:1304 CORDOBA RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-1411
Practice Address - Country:US
Practice Address - Phone:865-951-0523
Practice Address - Fax:865-974-5629
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health