Provider Demographics
NPI:1235338369
Name:BARBOUR, GEORGIA CAROL (RN, LCSW)
Entity Type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:CAROL
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:RN, LCSW
Other - Prefix:MS
Other - First Name:GEORGIA
Other - Middle Name:CAROL
Other - Last Name:SOUTHARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, LCSW
Mailing Address - Street 1:220 FORT SANDERS WEST BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3398
Mailing Address - Country:US
Mailing Address - Phone:865-531-4500
Mailing Address - Fax:865-531-4584
Practice Address - Street 1:220 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3398
Practice Address - Country:US
Practice Address - Phone:865-531-4500
Practice Address - Fax:865-531-4584
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000007141041C0700X
TNRN0000135558163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163W00000XNursing Service ProvidersRegistered Nurse