Provider Demographics
NPI:1346300720
Name:DICKEY, PAMELA AUSTIN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:AUSTIN
Last Name:DICKEY
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 1:2505 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-3313
Mailing Address - Country:US
Mailing Address - Phone:865-637-1753
Mailing Address - Fax:865-544-7150
Practice Address - Street 1:2505 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-3313
Practice Address - Country:US
Practice Address - Phone:865-637-1753
Practice Address - Fax:865-544-7150
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical