Provider Demographics
NPI:1295467462
Name:FAMILY DYNAMICS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:FAMILY DYNAMICS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHENOA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SHENANDOAH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:865-263-2200
Mailing Address - Street 1:318 N FOREST PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5127
Mailing Address - Country:US
Mailing Address - Phone:865-263-2200
Mailing Address - Fax:865-263-2300
Practice Address - Street 1:318 N FOREST PARK BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5127
Practice Address - Country:US
Practice Address - Phone:865-806-0566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty