Provider Demographics
NPI:1417720533
Name:UNDERHILL, TENNA (LCSW)
Entity Type:Individual
Prefix:
First Name:TENNA
Middle Name:
Last Name:UNDERHILL
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 1:1500 E CORSICANA ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-5104
Mailing Address - Country:US
Mailing Address - Phone:903-681-4444
Mailing Address - Fax:
Practice Address - Street 1:1500 E CORSICANA ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-5104
Practice Address - Country:US
Practice Address - Phone:903-681-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical