Provider Demographics
NPI:1225106834
Name:AUTEN, EMILY BEARDSLEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:BEARDSLEE
Last Name:AUTEN
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 1:6778 EXECUTIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1970
Mailing Address - Country:US
Mailing Address - Phone:423-805-2514
Mailing Address - Fax:423-513-2487
Practice Address - Street 1:6778 EXECUTIVE OAK LN
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1970
Practice Address - Country:US
Practice Address - Phone:423-805-2514
Practice Address - Fax:423-513-2487
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW38351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN800007611OtherMEDICARE RR
TN3124884OtherBCBS
TN3921087Medicaid
TN621754911OtherCHAMPUS
TNS71074Medicare UPIN
TN3921087Medicaid