Provider Demographics
NPI:1376739136
Name:DENISE M. STILLMAN, PHD., PC
Entity Type:Organization
Organization Name:DENISE M. STILLMAN, PHD., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:865-264-2400
Mailing Address - Street 1:6231 HIGHLAND PLACE WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4083
Mailing Address - Country:US
Mailing Address - Phone:865-264-2400
Mailing Address - Fax:865-588-6406
Practice Address - Street 1:1128 E WEISGARBER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2674
Practice Address - Country:US
Practice Address - Phone:865-264-2400
Practice Address - Fax:865-588-6406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3982651Medicare PIN